The nation's first opioids trial against a drug manufacturer opened this week in Oklahoma, offering hope that an industry that has so recklessly enabled and monetized a national crisis of addiction and drug trafficking will finally be held to account.
Opioids are highly addictive narcotics found in both illicit drugs like heroin and prescription painkillers like oxycodone. Overprescription of those painkillers — exacerbated by "doctor shopping" among addicts to obtain still more — spawned an overdose epidemic starting in the late 1990s that today is a leading cause of death for Americans under 50. The rise in addiction rates led to an explosion in heroin sales across the country.
Because opioids have a legitimate medical use in controlling pain, assigning blame to manufacturers for the damage these drugs have caused isn't as cut-and-dried as, say, assigning blame to tobacco companies for the cancer caused by their cigarettes. Cigarettes are intrinsically dangerous; there is no safe way to smoke. There are safe ways to use opioids.
In essence, that's the stance that the drugmakers are taking: that they just produce and sell a useful product and shouldn't be held responsible if some of their customers abuse it. It sounds like a compelling argument, but it ignores evidence that drugs were aggressively and deceptively marketed to both doctors and the public, minimizing their addictive nature and encouraging their overuse and misuse.
The industry also turned a blind eye to clear signs its products were being funneled into black markets — such as the revelation that one distributor shipped three million prescriptions in 10 months to a single pharmacy in a West Virginia town where only 400 people live.
Oklahoma Attorney General Mike Hunter has taken on pharmaceutical giant Johnson & Johnson himself instead of joining any of the hundreds of federal suits pending. The Oklahoma suit alleges the company was the "kingpin" behind the "worst man-made public health crisis" in the state's history, at a health care cost of billions of dollars and thousands of lives.
After taking hundreds of depositions, Hunter said recently, "we are even more convinced that these companies are the proximate cause for the epidemic in our state and in our country."
In court Tuesday, state lawyer Brad Beckworth laid out how Johnson & Johnson and others in the industry pushed opioids as "safe and effective for everyday pain" while minimizing the dangers of addiction — all while producing and selling far more of it than was needed for legitimate purposes.
"If you have an oversupply, people will die," Beckworth said.
Tobacco companies that for years engaged in aggressive and misleading marketing, even in the face of increasingly strong attempts government regulation, were finally brought to heel by civil litigation. How successfully Oklahoma follows that path could determine whether the beginning of the end of this epidemic is in sight.
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