State sues maker of OxyContin over opioid crisis

  • From left to right, Attorney General Jahna Lindemuth, Alaska Director of Public Health Jay Butler, Lt. Gov. Byron Mallott and Gov. Bill Walker appear at a press conference Oct. 31 to announce a lawsuit against Purdue Pharma, the manufacturer of OxyContin, that alleges the company is responsible for the state’s opioid epidemic. (Photo/Courtesy/Alaska Department of Law)

The State of Alaska filed a lawsuit against Purdue Pharma on Oct. 31, claiming the pharmaceutical company that makes the drug OxyContin used fraudulent marketing and is responsible for the widespread prescribing by doctors that resulted in Alaska’s opioid crisis.

The lawsuit was filed in Alaska Superior Court with backing from Gov. Bill Walker.

The governor tied the recent crime surge to the opioid epidemic.

“We have people becoming criminals to feed their habits,” Walker said in a prepared statement announcing the lawsuit. “We have grandparents having to take care of grandchildren because the parents have fallen into the spiral of addiction or worse, have died from an overdose. And the worst part is a lot of these people would have never become addicts without that initial prescription that went on too long.”

The 84-page filing begins by chronicling Alaska’s opioid crisis with the declaration by Gov. Walker on Feb. 14 of a public health emergency. The lawsuit contends that the crisis is stretching state resources to the point that state agencies can’t keep up.

Alaska’s lawsuit follows on the heels of those filed recently in Washington, West Virginia, New Jersey, New Mexico, Mississippi, Ohio, Missouri, New Hampshire, Louisiana and South Carolina.

Attorney General Jahna Lindemuth said her office hired the firm Motley Rice on a contingency fee basis this summer to investigate whether any manufacturers or distributors of opioids had violated state consumer protection laws. The investigation, as explained in the lawsuit, uncovered that the majority of Medicaid spending on brand-name opioids was for OxyContin.

The suit contends Alaska’s opioid epidemic is largely caused by Purdue Pharma’s actions to persuade doctors and patients that compassionate treatment of pain requires opioids.

Purdue has claimed such drugs may be used long-term to treat chronic pain without causing abuse and addiction. In response to lawsuits, the Stamford, Conn.-based Purdue said in a statement it was “deeply troubled” by the opioid crisis and that its U.S. Food and Drug Administration-approved products account for just 2 percent of all opioid prescriptions.

“We vigorously deny these allegations and look forward to the opportunity to present our defense,” Purdue said.

The company is owned by the billionaire Sackler family featured in a New Yorker magazine article this week. It is not a publicly traded company.

The state contends the opioid epidemic in Alaska is a direct outcome of medical treatment.

“The toll of opioid overuse, abuse, addiction, and death in the state is not the result of pain conditions warranting the use” of this class of these drugs, it states.

Prior to Purdue’s campaign, back in the late 1970s doctors only used opioids for short term acute pain or for cancer patients because the drugs were seen as “too addictive and debilitating to be used long term and inappropriate, therefore, for chronic pain,” the suit alleges.

But Purdue transformed medical thinking by persuading doctors that the risk of addiction is modest and outweighed by the patient benefits in reduced pain.

Patients also trusted opioids because their doctors prescribed them, according to a report from Alaska patients surveyed and cited in the lawsuit.

“Rather than dispel that false confidence, Purdue’s marketing deliberately stoked it,” the lawsuit states.

The prescription opioids are especially dangerous because it ties patients to a drug that can kill them, yet they cannot stop taking it due to the addiction. The state links current heroin addicts to patients who were first exposed to opioids in their prescriptions.

In 2011, Alaska saw 66 fatal opioid overdoses. By 2016, that number reached 96, adding up to 476 deaths over those six years, the lawsuit states, quoting state Department of Health and Social Services numbers.

“Beyond overdoses, Alaska hospitals have struggled to deal with other effects of the opioid epidemic. Doctors and administrators report dealing with patients who threaten violence or suicide if they are not given prescription opioids. One doctor describes opioids as a daily part of practice — from patients seeking refills to patients with complications from injecting opioids, to patents in active withdrawal from opioids,” the lawsuit states.

Depending on the day, 15 to 30 of the patients in one emergency department will be on issues related to opioids, an Anchorage doctor stated in the suit. Hospitals report dramatic increases in infections such as Hepatitis C and endocarditis or infections of the heart that are related to opioid abuse.

Police cases also record the epidemic. An increase in opioid supply and demand was reflected in Purdue’s OxyContin and generic oxycodone seized in Alaska. Seizers increased from 1,183 doses in 2014 to 4,552 in 2016.

“Prescription deaths have been linked to homicides, assaults, home-invasion thefts, property thefts, driving under the influence, prostitution, pharmacy robberies and the use of methamphetamines,” the lawsuit states.

In further showing the widespread problem, the Department of Law quotes a report that as many as 80 percent to 90 percent of Anchorage’s high school students report that the pain pills are readily available in their homes.

To get their products into more doctors’ hands, the suit alleges Purdue engaged in aggressive branding and giveaways: stuffed animals, CDs, clocks and luxury getaways for top OxyContin sellers and prescribers.

The state describes how Purdue used “key opinion leaders” or KOLs, to deliver paid talks providing information on treating pain and the risks/benefits of opioids.

“These KOLs served on the boards of patient advocacy groups and professional associations, such as the American Pain Foundation and the American Pain Society, that were able to exert greater influence because of their seeming independence,” the suit alleges.

Although this complaint has been filed, the Attorney General’s Office continues to investigate whether additional claims should be brought against other manufacturers and distributors, said Assistant Attorney General Cynthia Franklin.

The state makes six claims for relief. Unfair trade practices can include non-monetary relief such as cease and desist orders. It can also include restitution and a provision for civil penalties, Franklin said.

“The number of violations becomes a jury issue. When one of these lawsuits is tried, the jury determines the number of violations. Then the court assigns the dollar amount per violation. The minimum is $1,000 per violations and the maximum is $25,000 per violation,” Franklin said.

The state is not alleging a number of violations at this time, but it would be “somewhere in the several thousands,” she said.

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Naomi Klouda can be reached at naomi.klouda@alaskajournal.com.

Updated: 
11/01/2017 - 10:41am

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