How Opioids Became A Crisis
By Rick Outzen
The Panhandle Tiger Bay Club didn’t have its usual political speaker last week. On the program was Mike Papantonio, nationally-known trial attorney, bestselling author and accomplished jazz musician. His chosen topic was the opioid crisis.
More than 130 people die each day in the U.S. due to opioid overdoses, according to the Centers for Disease Control and Prevention. Abuse of opioids caused over 47,000 deaths in the U.S. in 2017, six times higher than the number of such deaths in 1999. The rapid rise in deaths prompted the Department of Health and Human Services to declare a public health emergency.
Papantonio and his firm, Levin, Papantonio, Thomas, Mitchell, Rafferty & Proctor, has made the decision to the sue the opioid manufacturers and distributors at the local level because “the counties and the cities all over this country that have had to build huge infrastructures—new EMTs, new police forces, new court systems—to be able to deal with this problem that is like a wildfire ravaging this country.”
Papantonio said cities and counties have had to raise taxes raised because they needed a bigger police department and an increased number of EMTs to answer the number of overdoses that were taking place every day. He wasn’t talking about treating just homeless drug addicts.
“Nothing is farther from the truth. The people I’ve met are people like soccer moms who had wonderful lives, raised wonderful families,” he told the luncheon crowd. “And then all of a sudden, they go, and they’re given a drug for seven days. And their system tells them, ‘I’m addicted.’ And they don’t even know they’re addicted.”
Papantonio shared documents that showed how pharmaceutical executives misled physicians and the public so sales would continue to increase. He shared a 2013 report by the General Accounting Office that reviewed “the history that was taking place with the narcotics industry.”
He said the federal government wrote the drug manufacturers saying, “A) Stop lying to the American public; B) What you’re representing in your clinicals is not accurate; C) How dare you tell the doctors that this isn’t addictive and that they can give as many of these as they want; and D) We want to know the basis of your statement, where you’re finding this stuff, because we can’t find it.”
According to Papantonio, the pharmaceutical companies didn’t take the drugs off the market. Instead, they expanded their sales forces. He said, “They go out, and they say, ‘We’re selling so much of this, we can’t even keep up with it.’ “
He alleged the strategy was to determine how to keep people on OxyContin longer. “So they did studies all over the country where they said, ‘Okay, if we keep them on OxyContin for 60 days, for example, we think we can probably extend it to 90 days. If we keep them on OxyContin for 20 days, we think we can keep them on OxyContin for 60 days.’”
Doctors were encouraged to increase dosages, according to Papantonio. He said the physicians were told, “No, you don’t give this to somebody when they’re hurting. You saturate their system all the time, and that is more successful in dealing with the pain.”
When doctors began to complain that their patients were getting addicted despite the drug companies’ research, the companies created a new medical term, “pseudoaddiction.”
“They would send representatives to the office and say, ‘Doc, I know you’re worried about addiction. What you’re seeing really isn’t addiction’” Papantonio told the audience. “‘It’s something called ‘pseudoaddiction.’ It’s something new. You know, it’s in the literature, but what you’re seeing here is not really addiction.’”
Another argument used by the manufacturers was that addiction was a disease, not an issue with the drugs. If a patient became addicted to OxyContin, the patient was the problem, not the medication.
Papantonio said, “Ladies and gentlemen, there’s been study after study after study that shows just the opposite. The genetic predisposition is a factor, but it is a minor factor.”
The attorney had few kind words for the Big Pharma executives he has deposed.
“Across the table from me, I’m dealing with a true-to-life sociopath,” said Papantonio. “They don’t look like a sociopath. They’re dressed up in an Armani suit. They’ve got a Rolex watch. They have an MBA from Harvard. And nevertheless, they make decisions that affect your life. And they’re going to walk away from it, and nobody’s going to be prosecuted. They’re going to pay money, and it’s going to be business as usual.”
He complained about how aggressively the criminal justice system punishes someone that is selling three ounces of marijuana on the street corner but doesn’t punish corporate executives.
He said, “Why do we treat that person different? We have to recalibrate, and we have to get control of this problem and understand they’re no different. They’re killing our kids, and we’re letting them go just by paying money. Time and time again, they pay money, and it’s get out of jail free.”
This fall, Papantonio will represent the state of Nevada in a lawsuit against Purdue Pharma L.P. and its affiliates, which manufacture OxyContin and other opioids. The lawsuit seeks civil penalties and damages for reimbursement and treatment and seeks to cease Purdue’s unlawful promotion of opioids on behalf of the state as a whole and the municipalities and counties.
Last week, Nevada Attorney General Aaron Ford filed an additional lawsuit against over 40 alleged opioid “conspirators”―including manufacturers, distributors, pharmacies and individuals―alleging they had created “an unprecedented public health crisis for their own profit.”
“This case arises from the worst manmade epidemic in modern medical history—the misuse, abuse, diversion and over-prescription of opioids,” said the court documents.
At the Tiger Bay luncheon, Papantonio said, “It’s all of them. It’s the distributors. It’s the manufacturers. The case I’m going to show in Nevada under RICO is they were all working together. They all understood exactly what was being told to the doctors, and they actually promoted these lies to the doctors. So when you start hearing doctors being accused of this, you need to understand what the reality is. The reality is the industry drove this.”
He said that eventually, he would like to see more than fines and settlements.
“They’ve made hundreds of billions of dollars, and they want out,” explained Papantonio. “And they want to say, ‘Well, we just want to pay you $20 billion, and gee, that’s a lot of money.’ Who in this room would not take a deal like that? Make $100 billion, and it cost you $20 billion. Who’s not going to take that deal?”
He would like to change the way big corporations do business in this country, “to where a kid coming out of MBA school in Harvard says, ‘You know, I’ll tell you a little scam Uncle John did 20 years ago. He put a product on the market he knew was dangerous, but he did a calculation. He figured out how many people were going to die. And he said, ‘Well, we can pay for those deaths and still make a big profit.’”
Papantonio added, “What person in this room could do the things I’m talking about and not end up in prison? So we have to change the way we think about this.”