America is in the grips of an opioid crisis. Years of misuse and an over-prescribing of the painkillers have left many patients struggling with addiction issues, and society grappling with the human and economic losses left in the drug’s wake . In 2016, opioids contributed to a record number of drug overdose deaths in the United States and amounted to billions of dollars lost.
Now, the issue of opioids is making its way into the courtroom, as multiple lawsuits have been filed against distributors and manufacturers of the drugs. Plaintiffs, in many cases governmental agencies, are charging that the pharmaceutical industry illegally distributed the painkillers and helped foster the current nationwide opioid epidemic.
Such lawsuits are being watched closely, as their outcomes could indicate how future litigation would go. Considering the scope of America’s opioid problem — the shattered lives, as well as the economic impact on society — it’s not unfathomable to imagine opioid litigation reaching the heights of the tobacco litigation of the late 1990s, when the tobacco industry paid out more $200 billion in settlements.
An American Crisis: What Are Opioids and Why Are We Addicted?
Opioids are a class of drug which encompasses the illegal drug heroin and synthetic opioids like fentanyl, as well as legal painkillers available with a prescription. The legal, prescription variety of opioids includes drugs such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine and morphine.
Opioids reduce pain by reacting with receptors on nerve cells in an individual’s body and brain. When prescribed by a doctor for a short period of time, opioids are considered generally safe and appropriate to use for pain relief.
But in addition to treating pain, opioids — ranging from the illegal, addictive and deadly street drug heroin, to the legally prescribed varieties — also provide a sense of euphoria. This is the reason opioids present a high risk for abuse.
According to the National Institute on Drug Abuse, misunderstanding the risk of abuse inherent with this class of drug helped fuel the present crisis the country finds itself in. In the 1990s, pharmaceutical companies began to aggressively market opioids to the medical community. Healthcare providers were assured by the industry that opioids were safe and did not present risks of abuse or addiction. Physicians, in turn, began to prescribe more and more opioids to their patients for pain relief.
Opioid prescriptions hit a peak in 2010, when the Centers for Disease Control and Prevention reports that there were 81.2 prescriptions per 100 people in the U.S. Many of these prescriptions were written for patients experiencing chronic pain issues.
Of course, the notion that opioids would not present high risks for abuse has now been found to be fatally flawed. And with the rise of opioid prescriptions, not coincidentally, also came a rise in opioid addiction and overdose rates. The NIH reports that more than 90 Americans die each day after overdosing on opioids, with 33,000 people in the country succumbing to opioid overdoses in 2015.
In addition, the NIH estimates that another 2 million people in the U.S. suffer from substance abuse issues related to opioids. The agency also estimates that 591,000 people suffer from heroin use disorder, which is notable as many patients seek out heroin or synthetic opioids when their prescriptions have run their course.
In recent years, with the recognition that opioids are dangerously addictive and rolling out of public awareness campaigns to combat their abuse, prescription rates have fallen. Down from its peak in 2010, the CDC pegged the rate at 70.6 opioid prescriptions per 100 people in 2015. That’s still a fair amount of opioids dispensed across America though, and the prescriptions, while there are less of them, tend to be for an increased number of days. And physicians in the U.S. are still prescribing three times as many opioids as they were in 1999, and three times as many as physicians in European countries.
While the prescription rate for opioids is falling in the U.S., the country is still in the midst of a crisis. With physicians writing less prescriptions, and a general push to curb and restrict the use of prescription opioids, patients, as well as individuals who obtained the prescription painkillers illegally in the past, are turning to heroin and synthetic opioids, like fentanyl.
According to a study by the National Center for Health Statistics, around 64,000 people died from drug overdoses in 2016. That’s a peak and it’s up from just under 20,000 deaths in 2000, with a considerable spike over just the last couple of years. While traditional culprits, such as cocaine and meth, are also on this list, opioid overdoses contribute markedly to this growing figure.
Notably, prescription opioid overdoses continue to rise, standing at 14,400 in 2016, but in recent years the number of heroin and fentanyl-related deaths has surged dramatically. In 2016 — with prescription opioids less available — heroin accounted for 15,400 overdose deaths, while fentanyl topped this grim list with 20,100 deaths.
Such staggering statistics are realized only after years of misuse of opioids by the pharmaceutical and medical communities. An unsettling number of individuals have been introduce to and hooked on opioids, and are now presenting the country with what the federal government is defining as a crisis.
Here are some additional statistics from the NIH and CDC regarding the opioid crisis:
- Between 21 and 29 percent of patients who are prescribed opioids for chronic pain misuse the painkillers.
- Between 8 and 12 percent of the patients develop an addiction to opioids.
- Of those who misuse prescription opioids, 4 to 6 percent of them transition to heroin.
- Among heroin users, 80 percent first abused prescription opioids.
Lawsuits Foreshadow Potential Wave of Litigation, or ‘The New Big Tobacco’?
With the recognition that America is wrestling with an opioid crisis, comes the realization of such a crisis’s roots: The country was introduced to opioids through conscious efforts of the pharmaceutical and healthcare communities.
With this realization has come governmental action, in the form of Congressional and Senate investigations as well as a multi-state investigation into various opioid manufacturers. The realization has also spurred an initial wave of lawsuits targeting pharmaceutical distributers and manufacturers and charging that the companies misled the public about the dangers of opioids, illegally distributed the painkillers and ultimately created a nationwide epidemic.
The primary targets of these lawsuits are opioid distributers, like Cardinal Health and McKesson Corp. and opioid manufacturers, such as Purdue and Teva. Also targeted by some of the suits are pharmacies, such as CVS and Walgreens. Many of the plaintiffs in this growing list of lawsuits that have been filed thus far in states across the country are governmental agencies, local city, county and state governments that are seeking to recoup public costs associated with the opioid crisis.
And that cost, the lost dollar amount attributed to the opioid crisis, is alarmingly high.
The CDC now estimates the economic burden resulting from prescription opioid abuse to be $78.5 billion a year. This cost includes economic losses resulting from lost productivity, addiction treatment, healthcare and the cost incurred in the criminal justice system.