It’s been a big year for holding massive corporations accountable for their actions, and pharmaceutical companies are not exempt. On Tuesday, San Francisco joined more than 1,200 other cities and counties across the nation in a slew of lawsuits targeting Purdue, McKesson, and other drug manufacturers for their role in the opioid epidemic. The 162-page suit was filed in federal court in San Francisco, but should be transferred to Ohio in the coming weeks, where U.S. District Judge Dan Polster has the tricky task of collecting and organizing each and every one.
The role that these for-profit corporations played in creating and fueling our nation’s addiction to opioids is no secret; entire books have been written on the matter. (We personally recommend Dreamland by Sam Quinones.) To very briefly summarize: Over the span of several years in the 1990s, drug companies began aggressively wooing medical professionals to prescribe heavy duty painkillers for various ailments. OxyContin was particularly hot, and a culture of “pain management” emerged, with doctors prescribing far more pills than would be needed for, say, a sprained ankle. Today we still see that trend continue — it’s hard to leave any dental surgery appointment without a prescription for 25 Vicodin, even if the pain is only expected to last a couple of days. At the same time as drug reps were buying doctors beef tenderloins and office swag in exchange for pushing the pills, a weakly-executed study stating that opioids were rarely addictive was making the rounds in pamphlets, medical conferences, and in doctors’ offices, despite growing evidence of the opposite.
The cumulative financial results of such over-prescribing were massive; from 1996 to 2012, global OxyContin sales increased from $48 million to more than $2.4 billion. And decades of over-prescribing opioids and under-educating patients about the adverse effects of the drugs have propelled the nation into a crisis of epic proportions. Some people who got hooked on pills found that heroin — particularly the sticky, black stuff coming up from Xalisco, Mexico — was easier and cheaper to acquire than prescription drugs. But the dangers of an illegal, unregulated supply are epic; in 2017 alone, 70,000 people died from drug overdoses, nearly 10 percent more than 2016.
In San Francisco, where we have more than 20,000 injection drug users, the costs of managing their health and recovery are exorbitant — and still woefully underfunded. So the suit is far from symbolic; it claims the companies engaged in fraudulent practices, negligence, conspiracy, and creation of a racketeering enterprise, all of which have created a “public nuisance.” In response, it asks for financial compensation for the millions it spends on treating addiction issues, requests an injunction to halt all false marketing, and demands oversight and accountability for the companies’ responsibility to report suspicious sales.
Despite overwhelming evidence that pharma companies played a massive role in our dependency on opioids, they claim that the main perpetrators are the doctors and users themselves. The Healthcare Distribution Alliance, which represents major pharmaceutical corporations, denies that their clients are the root cause.
“The misuse and abuse of prescription opioids is a complex public health challenge that requires a collaborative and systemic response that engages all stakeholders,” says Healthcare Distribution Alliance Senior Vice President John Parker. “Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated.”
Unluckily for pharma, they have a strong adversary; Polster rejected a request by the drug makers this week that charges of racketeering, conspiracy, and negligence be dropped.
“It is accurate to describe the opioid epidemic as a man-made plague, 20 years in the making,” he said. “The pain, death, and heartache it has wrought cannot be overstated. Whether plaintiffs can prove any of these allegations remains to be seen, but this court holds that they will have that opportunity.”
Bay City news contributed reporting to this story.