In Dayton, Ohio, the opioid crisis achieved a grim milestone earlier this year: For the first time ever, the local coroner’s office ran out of space to hold the corpses of those who had overdosed. Funeral parlors had to be recruited to take on temporary storage duties.
Indianapolis is not there yet. But the trend here is nearly as disturbing. Opioid addiction killed 345 people in Marion County last year. That was the highest number ever and four times more victims than all of the county’s traffic accidents put together.
Mayor Joe Hogsett announced last week that the city would be taking opioid manufacturers and distributors to court.
The website will house information such as data, facts, Indiana initiatives, ways to get involved, and information on opioid abuse treatment, prevention and enforcement.
“Left unchecked, opioid addiction will continue to incite criminality, tear apart families, and take the lives of Indianapolis residents,” Hogsett said in a statement. “As we work to combat this epidemic of addiction and connect affected community members with the treatment they need, those who have contributed to this crisis should be held accountable.”
The local crisis Hogsett refers to is part of a national problem. U.S. opioid overdose deaths (heroin plus prescription opioids) have quadrupled since 1999. By filing a lawsuit, the city of Indianapolis will follow the lead of dozens of states and cities that have already pointed the finger at the corporations that promoted and profited from the surge in pain medication prescriptions that preceded the addiction crisis. A Congressional investigation is also looking into the companies’ responsibility.
When Ohio Attorney General Mike DeWine sued pharma corporations in May, he did not shy away from assigning blame. “These companies got thousands and thousands of Ohioans addicted to opioid pain medications, which has all too often led to use of the cheaper alternatives of heroin and synthetic opioids,” he said. “These drug manufacturers led prescribers to believe that opioids were not addictive, that addiction was an easy thing to overcome, or that addiction could actually be treated by taking even more opioids.
“They knew they were wrong,” DeWine added. “But they did it anyway — and they continue to do it.”
The manufacturers and distributors identified as the likely targets of the planned Indianapolis lawsuit gave statements to the Indianapolis Star denying responsibility for the crisis.
But they will have a lot to answer for, as the epidemic followed on the heels of multiple companies spending billions of dollars pushing physicians and patients into a downward spiral of painkiller over-prescription and abuse.
Last week Gov. Eric Holcomb announced that Indiana is rolling out a program to closely monitor prescriptions for opioids
The promotions included lavish dinners and junkets for physicians, along with industry-produced literature that extolled the life-changing benefits of opioids while alleging multiple disadvantages of over- the-counter medications like ibuprofen. At the same time, the industry was using insider ties to rewrite medical guidelines to justify the rash of prescriptions.
The result: In 2010 alone, physicians wrote 254 million prescriptions for opioids, and pharmaceutical corporations raked in $11 billion in opioid sales. In Ohio, almost 20 percent of the state’s population was prescribed an opioid in 2016.
The most notorious marketing campaign centered around Purdue Pharma’s product OxyContin, which the company claimed would provide 12 hours of relief from each dose. (Purdue Pharma is not connected to Purdue University.) The lengthy duration distinguished OxyContin from cheaper alternatives, so it was the core of the company’s pitch to physicians and patients.
Except multiple clinical trials and physician reports eventually revealed that the drug’s effects did not actually last that long for many patients. When OxyContin’s effects wore off before the next scheduled dose, searing pain returned, which patients were desperate to alleviate. It was “the perfect recipe for addiction,” Theodore J. Cicero, a neuropharmacologist at the Washington University School of Medicine in St. Louis told the Los Angeles Times.
In 2007, Purdue Pharma and top executives admitted to felony fraud in their OxyContin promotions, paying fines of $634 million. Purdue is not alone: sales representatives from other companies have pled guilty to bribing doctors to prescribe painkillers, using lures that included speaking fees.
Yet the industry that has become one of the most profitable in modern history by exploiting the desperate needs of suffering people has been anything but chastened. In response to the spike in demand for the medicine naloxone to respond to overdoses, manufacturers increased its price by as much as 500 percent.
The state of Indiana has not yet joined the opioid litigation push, although Attorney General Curtis Hill is one of 41 state attorneys general conducting an investigation of companies’ role in the epidemic.
Widespread lawsuits aiming to recover government costs and deter unethical corporate behavior invoke comparisons to the 1990s claims against tobacco companies. In 1998, those suits concluded with the companies and 46 states reaching the largest civil litigation settlement in U.S. history.
Indianapolis will be the first city in Indiana to pursue this type of legal action.
No doubt, Indianapolis taxpayers would be happy if the opioid litigation brings similar results. The city could use the financial boost to offset the increased public safety, health emergency and legal system costs caused by the epidemic. But it would be even better if the lawsuits succeed in reducing the burden on coroners’ offices — here and across the country.