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Livingston County is among the latest in New York to sue opioid manufacturers, and Monroe County is considering legal action. Wochit

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As York County officials turn to the judicial system for help repairing some of the damage caused by rampant opioid abuse, lawyers for the companies they've sued are already fighting numerous lawsuits blaming them for launching the country’s opioid crisis.

York County sued two dozen opioid manufacturers, distributors and physicians Friday, Dec. 8, for aggressively marketing their drugs and lying about the risks of long-term opioid use — allegations many of the companies have heard, and paid out large settlements for, before. 

The lawsuit filed by county solicitor Glenn Smith takes aim at companies and individuals at each step of the opioid supply chain.

Four out-of-state physicians, three national drug-distribution companies and 17 opioid manufacturers are facing allegations they profited from the sale and use of drugs they knew to be harmful.

More: York County sues 25 opioid manufacturers, distributors

“This case is about one thing: corporate greed,” Smith wrote to begin the 250-plus-page lawsuit. “Defendants put their desire for profits about the health and well-being of the York County consumers at the cost of the (county).”

Defendants: York County’s lawsuit is the latest in a string of suits filed against Johnson & Johnson, Purdue Pharma, Teva Pharmaceuticals and Allegran — four of the largest prescription drug conglomerates in the world — and major distributors McKesson, Cardinal Health and AmerisourceBergen.

Of the 17 manufacturers sued by York County, 14 are subsidiaries of the four conglomerates. Endo Pharmaceuticals, based in Malvern, Pennsylvania, and Arizona-based Insys Therapeutics are the other opioid manufacturers named as defendants in the suit.

More: Opioid addiction treatments face off in U.S. trial

The lawsuit also will come as little surprise to the four out-of-state physicians named as defendants, who are facing similar lawsuits in several states. 

The physicians are accused of using their prominence and reputation as “pain experts” to lead a “sophisticated, highly deceptive and unfair marketing campaign” in the 1990s and 2000s to promote widespread and long-term opioid use.

Other suits, settlements: In the past year, dozens of state attorneys general and county district attorneys have filed suits against Johnson & Johnson, Purdue, Teva, Allegran and other drug manufacturers in an effort to recoup the additional costs of law enforcement, substance-abuse treatment and health care related to long-term opioid use and abuse.

More: Doctors’ offices a front line in opioid battle

The conglomerates named in York County’s lawsuit also are facing similar allegations of deceptive marketing in New Jersey, New York, Ohio, Wisconsin and New Mexico, among other states.

While none of these opioid lawsuits have yet reached a conclusion, some legal experts are projecting the total cost of settling opioid-related suits could come close to the $200 billion pricetag that the tobacco industry agreed to pay out in 1998 for deceptively marketing its products.

The county’s lawsuit does not request a specific sum of money if successful, instead seeking compensatory damages for added costs because of the defendants’ actions, punitive damages and legal costs. 

Several defendants named in York County’s suit are more than familiar with paying out large sums to settle suits about their products. 

Purdue agreed to pay $635 million in 2007 to settle criminal and civil charges for misbranding OxyContin, according to the lawsuit.

A year later, Cephalon agreed to pay $425 million in fines, damages and penalties for violating the Federal Food, Drug and Cosmetic Act with misleading promotions of three of its products, including a drug made from fentanyl, an opioid that’s 50 to 100 times more powerful than heroin.

The county’s lawsuit also points to a $44 million fine paid in December 2016 by Cardinal Health and a January 2017 agreement by McKesson to pay a $150 million penalty for failing to identify and report suspicious orders at a number of its facilities.

'Scapegoats': A senior official for Healthcare Distribution Alliance — a national trade association representing Mckesson, Cardinal Health and AmerisourceBergen — said in a statement Tuesday, Dec. 12, that distributors "understand the tragic impact" of the opioid epidemic but aren't at fault for creating it.

"We are deeply engaged in the issue and are taking our own steps to be part of the solution — but we aren't willing to be scapegoats," HDA Senior Vice President John Parker wrote in the statement.

The county's lawsuit alleges the three distributors shipped "millions of doses of highly addictive" opioids into York County between 2007 and 2016, and officials claim distributors should have investigated many of those orders as potentially suspicious.

"The Defendants manufactured and delivered an excessive and unreasonable amount of opioid pain medications to retailers in York County," the lawsuit alleges. "Upon information and belief, the Defendants did not refuse to manufacture, ship or supply any opioid medications to any pharmacy in York County from 2007 to the present."

Distributors coordinate "safe and secure storage, transport and delivery" of opioids from manufacturers to pharmacies, hospitals and physicians, Parker said.

"We don't make medicines, market medicines, prescribe medicines or dispense them to customers," Parker said. "Given our role, the idea that distributors are solely responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and how it is regulated."

‘Blockbuster profits’: In filing the lawsuit, York County joined a growing chorus of government agencies to sue opioid manufacturers and distributors for their role in creating the opioid epidemic, which continues to reach new depths since its unofficial start several years ago. 

More: Heroin overdoses spike in York County

According to York County Coroner Pam Gay, 19 people died in November from suspected opioid overdoses — the highest number she’s seen in a single month. In just the first five days of December, 10 people died from suspected overdoses, Smith said.

As of the start of December, the county had confirmed 93 heroin-related deaths and 35 suspected deaths in 2017 — 17 more confirmed deaths than last year’s total of 76, 28 more than the 2015 total of 65 and 31 more than the 2014 toal of 62.

In the lawsuit, Smith alleges the opioid companies and physicians knew “that opioids were addictive and subject to abuse” when used for chronic pain management but continued to push the drugs to boost their bottom lines. 

Opioid-based treatments were once used for “short-term post-surgical and trauma-related pain,” but after coordinated and aggressive marketing techniques to persaude doctors and patients opioids were not dangerous for long-term use, “chronic opioid therapy … is now commonplace,” according to the lawsuit. 

“Defendants’ scheme supplies both ends of the secondary market for opioids — producing both the inventory of narcotics to sell and the addicts to buy them,” the lawsuit alleges.

According to the lawsuit, Johnson & Johnson, Purdue, Teva and Allegran spent hundreds of millions of dollars to create a new market for opioids and earn “blockbuster profits” through creating misleading advertising, incentivizing the long-term use of opioids and buying off doctors, medical societies and patient-advocacy groups to promote opioids.

In doing so, the defendants “profited handsomely” while creating a breeding ground for addiction, overdose and death, according to the lawsuit.

Purdue recorded $45 million in revenue from its 1996 sales of OxyContin, but sales reached more than $3 billion in 2010, according to the suit. 

“It was Defendants’ marketing — and not any medical breakthrough — that rationalized prescribing opioids for chronic pain and opened the floodgates for opioid use and abuse,” Smith wrote.

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