Baltimore Sues Opioid Companies -- and a Local Doctors' Office
By Ian Duncan
Baltimore's law department filed a lawsuit Wednesday against opioid manufacturers and distributors over the marketing of addictive pain pills, adding the weight of the Maryland jurisdiction hardest hit by the overdose crisis to the legal campaign to hold the pharmaceutical industry accountable.
In announcing the lawsuit, filed in Baltimore Circuit Court, City Solicitor Andre Davis said he would personally be part of the team handling the case. Davis, a former federal judge, said the companies marketed the pills knowing they would be "destructive of lives."
"They were reckless, they were intentional, it was marketing, it was greed," Davis said.
More than 3,000 people have died of opioid overdoses in Baltimore since 2007 -- 523 of them between January and September of last year. The crisis, which has worsened as more drug users are exposed to the potent synthetic opioid fentanyl, shows no sign of easing.
Several counties in Maryland and jurisdictions across the country have brought similar cases. Anne Arundel County filed a lawsuit in state court and Cecil County filed one in federal court. Baltimore County is preparing a suit -- the County Council will vote Monday on a contract to hire a private law firm with the goal of joining federal litigation in Ohio.
Gov. Larry Hogan has authorized Maryland Attorney General Brian E. Frosh to bring a case for the state. Frosh says he is investigating but has too few resources to tackle the full scope of the overdose crisis.
Baltimore is asking the court to order drug companies to change how they do business. Davis said any money won by the city would go into municipal coffers as recompense for the policing and health costs associated with addiction and overdoses.
The city alleges that the drug manufacturers have funded unscrupulous research that led to biased findings about the dangers of opioid pills and spread false information to doctors and consumers. The city accuses distributors of failing to properly report suspicious pill orders as required under federal and Maryland law.
The city's lawyers say the result was an overdose epidemic in which Baltimore is one of the places hit hardest in the nation.
The companies targeted in the case "bear significant responsibility for the epidemic of substance abuse and death that has devastated much of the country."
The city names as defendants the drug makers Purdue, Cephalon, Janssen, Actavis and Endo Health Solutions and distributors McKesson, Cardinal Health and AmerisourceBergen.
Reached for comment Wednesday, representatives of the drug firms denied any wrongdoing. They said the companies are committed to making sure that the pills they make or distribute are used safely.
Unusually, the city also named two doctors who operate a pain clinic with locations in Towson and Owings Mills. The city alleges that the clinic was a "pill mill" -- an operation that "prescribers controlled dangerous substances without a legitimate medical purpose."
Dr. Norman B. Rosen, one of the doctors, denied the allegations. He called the claim that he was running a pill mill "absolutely ridiculous."
While Rosen was on the phone with a Baltimore Sun reporter Wednesday, a television news crew showed up at his office. He called his colleague, Dr. Howard Hoffberg, to brief him.
"People want a fight, I'll give them a fight," Rosen said.
Hoffberg, reached later, said his lawyers had told him not to make any comment on the case.
"I'm not in any way trying to hide," he said.
At its heart, the case revolves around how dangerous prescription opioids are, and what people involved in supplying them to the public knew about the risks.
Rosen said the number of overdose deaths is low when compared to the number of prescriptions written, and that limiting the supply of the pills would hurt people who need help treating their pain.
"The whole opioid crisis is overstated," Rosen said.
When OxyContin, one of the brands of pills, hit the market in the mid-1990s, studies have found, it was marketed as not especially addictive. But for many patients that turned out not to be true.
Relatively few deaths are attributed directly to overdoses of prescription pain pills. But the widespread practice of prescribing the drugs has been blamed for turning patients into opioid addicts, leaving them vulnerable to heroin and its powerful additive fentanyl.
The chances that the city and other jurisdictions have of succeeding in court remains unclear.
Earlier rounds of personal-injury lawsuits have found little success. Drug companies have been able to argue that individual patients didn't use the pills properly, or laid responsibility to the doctors who wrote the prescriptions and the regulators who signed off on the drugs.
Rebecca Haffajee, who teaches law and public health at the University of Michigan, says the cities and counties now suing might have more success. They have the resources to take on a long fight in court, and might be able to uncover evidence that manufacturers knowingly minimized the dangers of the pills.
"We've seen a number of settlements that are increasing in frequency," she said.
And while some jurisdictions might be willing to settle cases for cash payments, others could be motivated to see a case through to trial.
"Many are quite aggressive and do want to publicly hold these companies accountable beyond the money," Haffajee said.
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