ST. ALBANS — The City of St. Albans has joined state and county governments around the country in suing the nation’s leading manufacturers of prescription opioids.
The city filed suit against Purdue Pharmaceuticals, makers of Oxycontin, and a host of other drug manufacturers in federal court Monday. Also included in the suit were the nation’s leading distributors of prescription drugs including Rite-Aid and Walmart.
The 300-page filing alleges the companies violated the Racketeer Influenced and Corrupt Organizations (RICO) Act, engaged in negligent and fraudulent behavior, were part of a civil conspiracy, and were unjustly enriched as a result of this behavior.
“Manufacturers aggressively pushed highly addictive, dangerous opioids, falsely representing to doctors that patients would only rarely succumb to drug addiction,” the suit alleges. “These pharmaceutical companies aggressively advertised to and persuaded doctors to prescribe highly addictive, dangerous opioids, turning patients into drug addicts for their own corporate profit.”
Distributors, the city alleges, “breached their legal duties under state and federal law to monitor, detect, investigate, refuse and report suspicious orders of prescription opiates.”
“Opioid abuse, addiction, morbidity and mortality have created a serious public health and safety crisis” according to filing, a crisis which the city government is obligated to address.
Costs for which the city seeks relief include the cost of providing treatment for those with addiction, the costs related to law enforcement and public safety resulting from the opioid epidemic, and the costs of caring for children whose parents have been incapacitated by addiction.
The complaint outlines the extent of the opioid epidemic nationwide and how it has contributed to heroin use. More than 40 people die each day from prescription pain relievers, with the death toll reaching 64,000 in 2016, a 22 percent increase from 2015.
“By 2010, enough prescription opioids were sold to medicate every adult in the United States with a dose of 5 milligrams of hydrocodone every four hours for a month,” the suit states.
Moreover, the leading risk factor for heroin addiction is previous misuse of prescription opioids, according to published research cited in the suit.
Heroin overdoses tripled in just four years nationwide, according to the Centers for Disease Control.
In 2013, researchers put the cost of prescription opioid misuse and addiction nationally at $78.5 billion a year.
In Vermont, opioid overdose deaths nearly tripled between 2010 and 2018, while deaths caused by fentanyl increased 20 times.
“Opioids have become the most common gateway drug leading to the use and abuse of heroin, fentanyl and carfentanil,” according to the suit. “Opioid addicts are 40 times more likely to also be addicted to heroin and almost half (45%) of heroin users are also addicted to opioids.”
In Franklin County, at least 40 people have died from opioid related causes between 2013 and 2018.
In 2018, 54 Franklin County residents were treated with naloxone to prevent death from an opioid overdose.
Vermont’s health department in St. Albans, which includes areas beyond Franklin County, paid for 445 people to receive addiction treatment through Medicaid in the second quarter of 2018 alone.
At the same time, the number of opioid prescriptions in the county soared, reaching 85.7 prescriptions per 100 residents in 2016.
Prior to the 1990’s it was considered best medical practice to use opioid treatments for short-term pain only, both because of the risk of addiction and because there was scant evidence that opioids were effective for treatment of chronic pain. In addition, patients tended to develop a tolerance for opioids, reducing their effectiveness as a long-term pain killer.
However, manufacturers spent millions convincing doctors opiates were effective and safe for treatment of chronic pain by falsely denying or trivializing the risks and overstating the benefits, the suit alleges.
Specifically, the suit states manufacturers:
- “created and promoted the concept of ‘pseudoaddiction’ when signs of actual addiction began appearing and advocated that the signs of addiction should be treated with more opioids;
- “exaggerated the effectiveness of screening tools to prevent addiction;
- “claimed that opioid dependence and withdrawal are easily managed;
- “denied the risks of higher opioid dosages;
- “exaggerated the effectiveness of ‘abuse-deterrent’ opioid formulations.”
Those efforts, the city says, were “wildly successful,” resulting in $11 billion in revenue in 2010 alone.
That increase in prescriptions created “a flood of prescription opioids available for illicit use or sale (the supply), and a population of patients physically and psychologically dependent on them,” the city argues. “When those patients can no longer afford or obtain opioids from licensed dispensaries, they often turn to the street to buy prescription opioids or… even heroin.”
The suit details the means by which manufacturers promoted opioid use from paid advertising to physicians paid to speak about opiates at medical conferences, to the use of front groups such as the American Pain Foundation to promoted opioid use.
The defendants fraudulent conduct caused harm to the city directly through costs incurred by the city, such as law enforcement, health insurance and workmen’s compensation, and indirectly through the overall public health crisis created in the community, the suit claims.
The city is seeking financial recompense for costs incurred, disgorgement of profits, compensatory and punitive damages, and attorney’s fees.
Locally, the city is represented by Vanessa Branon Kittell. Also representing the city are a number of attorneys from around the country.
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