By Linda Cicoira — Accomack County is legally fighting the war on drugs. It has taken into account that “the number of Americans who died of drug overdose death in 2017 was roughly equal the number of Americans who died in the Vietnam, Iraq and Afghanistan wars combined.”
The county filed separately but joined other localities in blaming the local opioid epidemic on drug companies. It named 53 pharmaceutical companies in a lawsuit late last week and is asking for a circuit court jury to be impaneled to award a total of $58.6 million in damages.
The lawsuit wants $40 million in compensatory damages — money for damages, injury, or another incurred loss as a result of the negligence or unlawful conduct. It also asks for $350,000 per defendant in punitive damages, which is $18.55 million total from all defendants.
“Accomack County has been hit hard by the opioid epidemic,” documents stated that were filed by Accomack County Attorney Cela J. Burge and lawyers from firms in Norfolk, Va., Texas, and Tennessee. “For example, the rate of neonatal abstinence syndrome (NAS) in Accomack County has peaked higher than the statewide rate … during three of the last six years for which the data is available. The NAS rate peaked in 2015 at more than double the statewide rate. The reported rate of Hepatitis C among 18 to 30 years olds in Accomack County has jumped from zero in 2012 and 2013 to 135.1 cases per 100,000 people in 2016.”
“Perhaps even more disturbingly, the rate of overdose deaths in Accomack County has steadily risen from 4 to 5.9 deaths per 100,000 people in 1999 to 14 to 15.9 deaths per 100,000 people in 2016,” the lawsuit continued. “The acute opioid problem in Accomack … reflects the overwhelming epidemic affecting the entire commonwealth,” the lawsuit continued. It noted that three years ago, the state health commissioner declared the issue a public health emergency.
Montgomery, Alexandria, and Dickerson counties are among the local governments fighting back with a lawsuit. The city of Bristol, Va., also filed a $40 million suit and localities in Tennessee, Florida, Nevada, North Carolina, North Dakota, and Texas are suing.
Purdue Pharma reached a $270 million settlement with the state of Oklahoma in March. Oklahoma Attorney General Mike Hunter reportedly streamlined his case against the remaining companies in the lawsuit and expects to go trial in May. Oklahoma will be the first of 36 states — at last count — to sue the opioid companies. New York joining in March and Illinois reportedly joined this week. There are more than 1,600 individual federal cases in the mix that are being overseen by a federal judge in Ohio.
Accomack’s lawsuit states the case can be filed locally because the drugs are sold here.
In Kentucky, the attorney general filed a lawsuit that focuses on the marketing of Opana ER, also known as oxymorphone, that is used to treat chronic pain, according to the American Bar Association.
Opioids are defined by the U.S. Department of Health and Human Services as
“a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. When used correctly under a health care provider’s direction, prescription pain medicines are helpful. However, misusing prescription opioids risks dependence and addiction.”
“On average, three Virginians die of a drug overdose and over two dozen are treated in emergency departments for drug overdoses each day,” the papers stated. “Fatal drug overdose in the first half of 2016 increased by 35% compared to the same period in 2015. More Virginians die each year from drug overdoses than motor vehicle accidents.”
The county also blamed the pharmaceutical companies’ “opioid-related misconducts” for the hike in heroin abuse. “A 2015 study found four out of five heroin users report that their addiction started with opioid pain relievers.” The drugs the defendants “provided to patients for everyday conditions such as knee pain, headaches, and dental pain – can operate as a gateway drug to heroin use and involvement with the illegal drug market.”
“Accomack County is now having to allocate substantial taxpayer dollars, resources, staff, energy and time to address the damage the opioid scourge has left in its wake and to address its many casualties,” the lawsuit continued. It blamed the rise in incarceration and the crime rate on the crisis.
“The cost that the county has borne for foster care and other child placement services have similarly increased” because the structure of families has been destroyed, the suit states.
The companies that were named include locally recognized names like Walgreens Company, CVS Pharmacy Inc., and Express Scripts Inc. Also named were Purdue Pharma L.P.,Purdue Pharma Inc.,The Purdue Frederick Company Inc., Rhodes Pharmaceuticals L.P., Abbott Laboratories, Abbott Laboratories Inc., Abbvie Inc., Mallinckrodt PLC, Mallinckrodt LLC, Specgx LLC, Endo Health Solutions, Endo Pharmaceuticals Inc., Par Pharmaceutical Companies Inc., Par Pharmaceutical Inc., TEVA Pharmaceuticals USA Inc., Cephalon Inc., Barr Laboratories Inc., Watson Laboratories Inc., Actavis Pharma Inc., Actavis LLC, Janssen Pharmaceuticals Inc., Ortho-McNeil Janssen Pharmaceuticals Inc., Jannsen Pharmaceutica Inc., Allergan PLC, Allergan FInance, LLC, INSYS Therapeutics Inc., KVY-Tech Inc., Amneal Pharmaceutical LLC, Impax Laboratories LLC, Amneal Pharmaceuticals Inc., Amneal Pharmaceuticals of NY LLC, Mylan Pharmaceuticals Inc., McKesson Corporation, McKesson Medical-Surgical Inc., Cardinal Health Inc., Amerisourcebergen Drug Corporation, Henry Schein Inc., General Injectables & Vaccines Inc., Insource Inc., CVS Health Corporation, CVS TN DIstribution LLC, Walgreens Boots Alliance Inc., Express Scripts Holding Company, Caremark RX LLC, CaremarkPCS Health LLC, Caremark LLC,Unitedhealth Group Incorporated, Optum Inc., OptumRX Inc., and DOES 1-100.
“Defendants efforts to deceive and make opioids widely accessible have also resulted in a windfall of profits,” the attorneys wrote, “Opioids are now the most prescribed class of drugs, they generated $11 billion in revenue for drug companies in 2014 alone. While Americans represent only 5% of the world’s population, they consume 80% of the world production of prescription opioids. The side effects of opioid use have provided even more profits for drug manufacturers. For example, television airwaves are now flooded with advertisements for remedies for the most common opioid-related side effect, opioid-induced constipation, which increases long-term opioid user’s healthcare costs by over $10,000.”
“The complaint states that the epidemic has resulted in economic social and emotional damage to tens of thousands of Americans through virtually every community in the U.S. It is indiscriminate and ruthless. It has impacted across demographic lines harming every economic class, race, gender and age group. It is killing Americans more than 134 people every day. Prescription and illegal opioids account for more than 670% of overdose deaths in the U.S. a total that has quadrupled over the past two decades,” according to the U.S.Centers for Disease Control and Prevents. “More people died from opioid-related causes in 2016 than from car accident or guns. In 2016, more than 175 people died every day from drug overdoses, compared to an airplane crashing, killing everyone on board every day. In 2017, the number rose to over 197, the increase largely due to synthetic opioids.” According to the CDC. The costs of healthcare lost productivity, addiction treatment and criminal justice involvement due to opioid misuse alone is $78.5 billion a year.”
Captain Todd Wessells, of the Accomack County Sheriff’s Office, who is running for the top spot in his department in November, has been involved in training for narcan and other anti-drug campaigns locally. A forum that was hosted by Brian Moran, Virginia’s secretary of public safety and homeland security, was offered last year.
Wessells was not available for comment Monday night. Burge did not answer an email earlier in the evening.
A documentary film on the impact of Eastern Shore opioid addiction, “Broken Dreams,” about a young woman who died from an overdose, was made and shown at the session. Special Agent Scott Wade, of the state police, who heads the Eastern Shore Drug Task Force, made it a mission to get the story filmed. It featured a local mother’s nightmare about opioid abuse. Her daughter, Katelynn Sterling, of Saxis, was only 20, when she died in July 2016, from complications of heroin addiction. Holly Sterling described her daughter as a fun-loving, bright cheerleader and student before she started using drugs. The changes began in her daughter when she was 15. Over more than five years, she started smoking marijuana, dropped out of high school, got into harsher drugs like cocaine, and then began doing heroin, first orally, then sniffing and then intravenously “until she was a full-blown heroin addict.”
Wade declined to comment on the lawsuit Monday. He is frequently in the courtroom when many of the drug distribution cases are being conducted. Accomack has seen trials for heroin, cocaine, meth, and designer drugs.
The state gave $100,000 of the $10 million spent statewide to the Eastern Shore Community Services Board in 2017 to help prevent opioid addiction but the area got no money to fund rehabilitation needs or for treatment medication despite a high death rate per capita for overdoses. A local 2016 study, required for the money, pointed to highest addiction rates for those in the 16 to 24 age group and police and other focus group members speaking out about drug abuse on the Shore, including bad situations at local high schools.
The lawsuit emphasized the “burden on law enforcement because of the sales on the black market and other crimes like theft associated with the desperation of addicts.
“Accomack County’s budget has been significantly and negatively impacted,” the lawsuit stated. The monetary value of what has been spent or the increased was not noted in the documents.
“Prescription drug manufacturers, wholesalers/distributors, and pharmacy benefit managers have created this epidemic,” the lawsuit stated. “The manufacturers make the opioids and lie about their efficacy and addictive properties. The wholesalers distribute the opioids from the point of manufacture to the point of delivery to the patients,” the suit states. “Control through their pharmacy plan design and formulary management, which drugs go where and how they are paid for,” is part of the process. “Drug overdoses are now the leading cause of death for Americans under the age of 50,” the suit continued.
A clerk in the court office said there had been numerous calls from the defendants Monday.
One company, CVS, has a link on its website about the crisis. The company said its work in communities supports health care access and includes “work to mitigate and prevent prescription drug abuse.”
“Our expansive reach, expertise, and access to local communities have uniquely positioned us to help address prescription misuse and abuse with an enterprise-wide approach. In 2018, we continued to expand our efforts through a variety of programs and initiatives, including education, safe prescription drug disposal, advocacy and collaboration with partners.” The company released a 2018 Corporate Responsibility Report that can be viewed at https://cvshealth.com/social-responsibility/our-opioid-response and invited users to visit the full response at https://cvshealth.com/social-responsibility/our-opioid-response
Walgreens, which also operates locally, has a similar website at https://www.walgreens.com/topic/pharmacy/combat_opioid_abuse.jsp
Doctors offices also have procedures in place to address opioid use. Eastern Shore Rural Health, which operates local doctors offices on the Eastern Shore, for example, demands that patients who take prescription pain relievers enter contracts that require them to take random drug screens and promise not to get pain relievers from other physicians. Surgery patients at medical centers are also being given fewer pain medications just after surgery and during physical therapy.
This story will be updated as it develops.