There have been 308 reported opioid overdoses in Pinal County in the past two and a half years.
Pinal County is taking on big pharmaceutical companies over opioid addiction. The law firms of Fennemore Craig and Theodora Oringher filed suit for the county in Superior Court Sept. 25.
“We know how many pills were forced into our county,” County Attorney Kent Volkmer said. “Every pill is tracked by the federal government. Needless to say, it falls far outside of appropriate norms.”
In suing many large drug manufacturers and all pharmacies that do business in Pinal County, Volkmer said his office is not as interested in getting a monetary award from the case as it is the opportunity to litigate it in the public forum.
Among the 50 defendants named in Pinal County vs. Actavis LLC, et al. are American Drug Company, Costco, Walgreens, Osco Drug, Walmart, Bashas’, Johnson & Johnson, Mallinckrodt LLC, Safeway, Par Pharmaceuticals, Smith’s Food & Drug, Sun Life Family Health Center and Watson Laboratories. The suit also names eight members of the Sackler family, who Bloomberg estimates to be worth $13 billion collectively.
By filing suit at the county level rather than joining the many federal-level lawsuits, Volkmer said, there is a better chance of getting the evidence known. Ongoing suits against the Sackler family, owners of Purdue Pharma, brought by states and other levels of government, will likely be filed into a national settlement. At the federal level, a U.S. bankruptcy judge paused those lawsuits against Purdue Pharma in October.
But Purdue and the Sacklers are only part of the Pinal County suit.
“We are prepared to litigate it. We want a jury to hear what they did and to determine a remedy,” Volkmer said. “We’re confident they acted badly. We want the public to know. The best way to get that is to try the case.”
The complaint does not cite a number for the monetary damages the county is seeking from the 50 defendants named. It seeks “to recover all measure of damages permissible under the statutes identified herein and under common law, in an amount to be proven at trial.”[quote_box_right]“We’re confident they acted badly. We want the public to know. The best way to get that is to try the case.” – County Attorney Kent Volkmer[/quote_box_right]
Volkmer said opioid addiction has cost the county manpower in law enforcement and health. And it is removing once-productive people from the economy because they can no longer work, shrinking the tax base that helps pay for the services impacted by opioid addiction.
Patients who could no longer afford an opioid prescription sometimes turned to heroin, causing more impact on law enforcement, the medical examiner’s office and county health resources. “And all of this cost was foisted on the county,” Volkmer said.[quote_box_right]“Janssen fully recognizes the opioid crisis that exists in this country. But one thing is clear: Janssen’s medications did not cause or contribute to that crisis.” – Janssen Pharmaceuticals[/quote_box_right]
The county complaint opens with the statement, “Opiates are killing people every day in this country and Arizonans have not been spared. Each of the [d]efendants in this action engaged in an industry-wide effort to downplay the dangerous and deadly potential effects of the misuse of prescription opioids. The opioid epidemic has hit every community in Arizona hard, including Pinal County.”
One of the defendants, Beverly Sackler, died Oct. 15 at the age of 95. Purdue filed for bankruptcy in September.
U.S. Bankruptcy Court Judge Robert Drain gave Purdue Pharma, the Sacklers and the government entities suing them until Nov. 6 to reach a disclosure plan that would show how much the company earned from OxyContin sales.
Fennemore Craig was hired by Pinal County this summer specifically for this case against Big Pharma. Its attorneys claimed the actions of opioid manufacturers were “a sophisticated, manipulative scheme” particularly designed to be effective in places like Pinal County because it “is home to a multitude of economically and medically vulnerable populations that defendants knew were uniquely predisposed to opioid addiction, including the elderly.”
Big Pharma companies, Volkmer said, are “lining their pockets” as a result of front-end and back-end domination of a field they created. Some of the same companies that make the opioids also make the overdose antidote naloxone, he said.
Those companies include Hospira (acquired by Pfizer) and Mylan, both named in the suit, which describes both as “a top manufacturer of fentanyl, oxycodone, morphine and codeine in Pinal County.” Mylan is further accused of withholding ingredients to treat “opioid-use disorder and opioid addiction” from its competitors.
Pinal County also accuses Janssen Pharmaceuticals and its parent company, Johnson & Johnson, of pushing “bogus research” to promote opioids.
It is similar to claims made in other cases against Janssen in Oklahoma and Ohio, where Janssen denied wrongdoing, stating in court papers: “Janssen fully recognizes the opioid crisis that exists in this country. But one thing is clear: Janssen’s medications did not cause or contribute to that crisis… Janssen will prove that its marketing was and remains supported by scientific medical evidence, offered in good-faith and without a scintilla of fraudulent intent.”
In the mid- to late-1990s, physicians started classifying pain as a “fifth vital sign.” That was allegedly pushed by the American Pain Society and resulted in pharmaceutical companies putting more attention on creating and marketing pain medication. Recent lawsuits from 23 states, as well as Pinal County’s suit, characterize the pharmaceutical companies as “pushing” drugs and turning up the heat on doctors to prescribe more.
Prescribed opioids like oxycodone and hydrocodone became commonplace.
“They said opioids addressed and alleviated pain. It was a miracle cure, supposedly,” Volkmer said.
He said, despite a lack of public research, opioids were marketed as addiction-free. Doctors who did not prescribe opioids to help their patients overcome perpetual pain virtually were “accused of malpractice.”
In Massachusetts’ claim against the Sacklers, they were accused of hiring hundreds more sales representatives to pressure doctors. “They directed reps to encourage doctors to prescribe more of the highest doses of opioids. They studied unlawful tactics to keep patients on opioids longer and then ordered staff to use them,” the Massachusetts’ complaint reads.
After the medical community started to acknowledge people were becoming addicted around 2010, the number of prescriptions began to decrease but the amount prescribed increased.
Harinder Takyar is the only physician named in the suit while other local doctors are grouped as so-called “John Does.” Takyar was a Florence-based doctor who was charged with 42 counts of prescribing opioids to his patients without medical need in 2014.
Gov. Doug Ducey declared a statewide emergency in 2017 after a health report found 790 Arizonans died of opioid overdoses the previous year. State tracking showed 431 million opioid pills were prescribed in 2016, “enough for every Arizonan to have a 2.5-week supply.”
Since the emergency declaration, between June 15, 2017, and Oct. 10, 2019, the Arizona Department of Health Services reported 3,633 deaths that were suspected of being opioid overdoses.
Volkmer said while the Pinal case is “very, very similar to Big Tobacco,” immediacy is the difference.
“If you smoke, in 20 or 30 years, you could get cancer,” he said. “Opioids have an immediate impact. It renders people unable to work. If one of my employees goes outside for a smoke break, they can come back to work. If they go out to pop a Percocet, they won’t be able to do that.”
Volkmer said he is “fairly optimistic” the case can be in court in 18-24 months.
This story appears in the the November issue of InMaricopa.