German Lopez

US officials are starting to treat opioid companies like Big Tobacco — and suing them

Annual Review of Public Health


It is impossible to talk about the causes of the opioid epidemic without pointing to the manufacturers and distributors that marketed and proliferated these dangerous pills. Yet over the past several years, these multibillion-dollar companies have avoided much in the way of serious accountability.

Until — maybe — now.

This year, multiple lawsuits have been launched against opioid manufacturers and distributors. With the opioid crisis now having resulted in more than 300,000 deadly opioid overdoses since 1999 (greater than the population of Cincinnati), there’s a push to hold accountable the people and companies behind the products that spawned the epidemic.

One of those lawsuits came from Ohio, which sued five opioid manufacturers and their subsidiaries. The state’s Republican attorney general, Mike DeWine, said that these companies knowingly misled patients and physicians about the drugs’ risks.

“They knew they were wrong, but they did it anyway — and they continue to do it,” DeWine said in a statement. “Despite all evidence to the contrary about the addictive nature of these pain medications, they are doing precious little to take responsibility for their actions and to tell the public the truth.”

DeWine even compared opioid manufacturers to tobacco companies, arguing in the lawsuit that opioid manufacturers are “borrowing a page from Big Tobacco’s playbook.”

Previously, the Cherokee Nation also made headlines when it announced it was suing opioid distributors and pharmacies, including CVS, Walgreens, and Walmart, for their involvement in supplying the pills to the Cherokee population. At the center of their claim: data that shows 845 million milligrams of opioids were distributed in the 14 counties that make up the Cherokee Nation — which, if you assume an average pill size of 20 milligrams, amounts to 360 pills for each prescription opioid user in the Cherokee Nation.

These lawsuits get to the two major legal arguments that different jurisdictions are raising against opioid makers and distributors:

Starting in the mid-1990s, opioid manufacturers unleashed a misleading marketing push underplaying the risks of prescription opioids and exaggerating the drugs’ proven benefits. This, the lawsuits argue, adds up to false advertising with deadly consequences — by encouraging doctors to overprescribe the pills and getting patients to think the pills were safe and effective.
Opioid distributors supplied a ton of these pills, even when they should have known they were going to people who were misusing the drugs. This is backed by data that shows that in some counties and states, there were more prescribed bottles of painkillers than there were people — a sign that something was going very wrong. Federal and some state laws require distributors to keep an eye on the supply chain to ensure their products aren’t falling in the wrong hands. Letting these drugs proliferate, the lawsuits say, violates those laws.
Opioid manufacturers and distributors, of course, ferociously deny these allegations. While some suits have been settled, and some executives have even been criminally convicted for their involvement in the epidemic in the past, opioid companies vigorously reject the argument that they have carelessly fueled the current drug crisis. And so far, what the companies have paid by and large amounts to peanuts compared with the profits they’ve taken in from the drugs.

Still, more lawsuits are coming, with New Hampshire most recently joining the fray with a suit against OxyContin producer Purdue Pharma. And according to the lawyers who have worked and advised on these cases, a growing number of jurisdictions are showing interest in such legal challenges. The ultimate hope is this could all lead to some sort of massive settlement — one that would quash the practices that helped lead to the deadliest drug overdose crisis in American history.

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