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Ohio Blames, Sues Drugmakers for Opioid Crisis

In a case reminiscent of the battle against tobacco, the state of Ohio on Wednesday sued five major drug manufacturers, blaming their marketing practices for fueling a painkiller addiction crisis that claims thousands of lives a year.

By Jim Provance

In a case reminiscent of the battle against tobacco, the state of Ohio on Wednesday sued five major drug manufacturers, blaming their marketing practices for fueling a painkiller addiction crisis that claims thousands of lives a year.

Attorney General Mike DeWine filed the suit against the makers of such drugs as OxyContin, Percocet, Dilaudid, and Percodan in Ross County Common Pleas Court.

"Pharmaceutical companies spent $168 million to sales reps peddling prescription opioids to win over doctors with their smooth pitches and glossy brochures that downplayed the risk and highlighted the benefits," Mr. DeWine said.

The suit seeks an unspecified amount of damages and an injunction to halt the practices of Purdue Pharma, Endo Health Solutions, Teva Phamaceutical Industries, Johnson & Johnson, Allergan, and a variety of their subsidiaries.

The lawsuit does not name individual doctors, nor does it go after drug distributors. It contends the companies intentionally and irresponsibly marketed their brand-name and generic opiate products for treatment of chronic pain, rather than just short-term pain or end-of-life care.

It claims they've spent millions to downplay the risks of addiction and undermining the warnings of the U.S. Surgeon General; Centers for Disease Control and Prevention, and the Food and Drug Administration, while also ignoring their own small-print warnings on their packaging.

Although a number of other states have gone after manufacturers and distributors to some degree, Mr. DeWine is just the second state attorney general, following Mississippi's, to file such a suit.

Like the successful suits more than a decade ago against tobacco companies, this one seeks an injunction against the manufacturers to halt their sales practices and seeks unspecified damages to reimburse the state for its costs in fighting the addiction epidemic.

It also urges payment to consumers who paid for drugs that are considered unnecessary for chronic pain.

Mr. DeWine picked Ross County for the suit because southern Ohio was seen as Ohio's ground zero for an epidemic of painkiller and heroin addiction that has since spread across the state. As so-called "pill mills" were shut down, many addicts turned to heroin for a cheaper and easier-to-obtain fix.

"Small towns were rocked as men, women, and children succumbed to addiction," he said. "From there the fires spread out across Ohio, touching every community and every county, no matter how rich or poor. It was a fire stoked by greed."

"We firmly believe the allegations in this lawsuit are both legally and factually unfounded," said Jessica Castles Smith, spokesperson for Johnson & Johnson subsidiary Janssen Pharmaceuticals Inc.

"Janssen has acted appropriately, responsibly, and in the best interests of patients regarding our opioid pain medications, which are FDA-approved and carry FDA-mandated warnings about the known risks of the medications on every product label," she said. "Our opioid pain medications give doctors and patients important choices to help manage the debilitating effects of chronic pain."

In a statement, Purdue said, "We share the attorney general's concerns about the opioid crisis, and we are committed to working collaboratively to find solutions.

"OxyContin accounts for less than 2 percent of the opioid analgesic prescription market nationally, but we are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone -- all important components for combating the opioid crisis," it said.

When asked why he filed the suit now, after more than six years in office, Mr. DeWine said the time was right.

"One, I felt we had enough to go on," he said. "I thought we had enough to go to court. And quite candidly, I think it's my moral obligation to this. I don't want to look back 10 years from now and say we should have had the guts to file it, we should have had the guts to call a spade and spade, the guts to say what really happened, however unpleasant that is or that people don't like it."

He is expected to seek the Republican nomination for governor next year, and opiate addiction has emerged as a major issue in the race. Democratic candidates have blamed the current Republican-controlled government of not doing enough to fight the epidemic, or help those addicted, and go after the major pharmaceutical companies.

"Now we know that an average of 11 Ohioans died every single day from drug overdoses last year," Ohio Democratic Party Chairman David Pepper said. "That was a 36 percent increase over the previous year.

"DeWine's call for litigation today is acting on a suggestion that Ohio Democrats have offered on multiple occasions, going back years," he said.

The path from prescriptions to addiction is a familiar theme for those in Toledo's addiction treatment community.

Dr. Steven Dood, a Waterville physician and medical director at the Lucas County jail, said it was appropriate to include drug companies in attempts to recover from the damage of the state's addiction crisis.

"This was inevitable that someone had to go to the ultimate source of the pills," he said.

Sharon Hawkins is president of AMAL Center of Hope in South Toledo, which offers a variety of services including intensive outpatient treatment and counseling.

"If I look at percentages of people who talk to us, an excess of 90 percent of them who are currently on heroin started out on pain medication," she said. She worked on the administrative side of addiction treatment since the 1990s and moved to the clinical side after her granddaughter formed an addiction that began with pain pills prescribed after surgery.

"The script got filled and refilled several times," she said. "She liked the way it made her feel, and she became addicted."

In Ross County on Wednesday, Christina Arredondo stood next to Mr. DeWine as he announced the lawsuit. Her daughter, Felicia Detty, became addicted to prescribed opioids and died of an overdose in 2015. She was six months pregnant.

"They had the ability to just consume all of our communities to fill what, their pockets?" she said. "I think that this will help some of it, because they're still creating the addiction every single day."

Staff writer Lauren Lindstrom contributed to this report.

(c)2017 The Blade (Toledo, Ohio)

Caroline Cournoyer is GOVERNING's senior web editor.
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