Sharing the Pain
Wednesday, July 4, 2018
SHARING THE PAIN: With Whatcom County facing legal action for its glacial pace in developing a therapy protocol for jail inmates who suffer addiction issues from painkillers, the other housekeeping arrived last week as the county joined a class-action lawsuit against the manufacturers of those prescription drugs.
In June, the American Civil Liberties Union of Washington filed a class-action civil rights lawsuit against Whatcom County and the Whatcom County Sheriff’s Office for denying people with opioid use disorder (OUD) in the County Jail medications necessary to treat their addiction and ease their withdrawal. Sheriff Bill Elfo reported to Whatcom County Council that a medication-assisted treatment protocol for inmates had been under development at the jail for some time, but had not been fully initiated.
County Council, meanwhile, had been for some time considering their own initiative, joining the widening legal fight against makers and wholesalers of prescription opioids, claiming they have contributed to a public health crisis.
“There is a fairly strong record that certain pharmaceutical companies engaged in deceptive practices with doctors and patients about whether these products would be addictive, and aggressively over-encouraged physicians to overprescribe them,” Council member Todd Donovan explained.
In April, County Council voted unanimously to retain legal counsel to join Everett, Tacoma, and other communities around the state in lawsuits against the distributors of over-prescribed painkillers.
The Whatcom County Prosecutors office confirmed last week that legal documents had been filed in a federal lawsuit against Purdue, Endo, Teva Pharmaceuticals, Mallinckrodt, and Janssen, the largest manufacturers of prescription opioids in the United States, as well as AmerisourceBergen, Cardinal Health, and McKesson, the three primary wholesale distributors of prescription opioids in the country.
The lawsuit seeks damages from these companies for their role in creating the opioid crisis that has seriously impacted Whatcom County and communities nationwide, and alleges that they violated the Washington Consumer Protection Act and federal corrupt enterprise statutes (RICO).
Prescription opioids are a class of powerful pain relievers, including oxycodone and hydrocodone. The chemical make-up of these prescription drugs is nearly identical to heroin. Opioid-related overdoses are the leading cause of death in the United States, surpassing fatal car accidents. Since 2000, more than 300,000 people have died from fatal opioid overdoses.
The ultimate goal of this and similar actions from municipalities across the state is to bring these companies that have profited greatly from the manufacture and distribution of a heavily marketed addictive product into the constellation of financial solutions to address a public health epidemic.
“The goal for Whatcom County is to get some kind of judgment that requires these companies to help mitigate [these issues] and help us support programs to combat opioid addiction,” Donovan said.
In May 2007, Purdue Pharma, producer of oxycontin, pleaded guilty to misleading the public about the drug’s risk of addiction and agreed to pay $600 million in one of the largest pharmaceutical settlements in U.S. history. The City of Everett successfully initiated a lawsuit against Purdue based on increased costs for the city from the use of oxycontin.
Research indicates that 80 percent of those addicted to opioids and opiates of any form began their addiction with prescription painkillers. One study by Johns Hopkins Center for Drug Safety and Effectiveness estimated the volume of prescription opioids in circulation in 2017 amounted to 52 pills for every American.
In Whatcom County, 30 percent of residents surveyed reported experiencing a situation where they or someone they know personally had medicines taken from them for use or abuse by someone else.
“In Whatcom County, the opioid crisis has become a public health emergency, and the costs to the county have been substantial,” Deputy Civil Prosecutor Karen Frakes noted in her narrative. “Between 2002-2004 and 2011-2013, the number of deaths attributed to opioids rose over 300 percent in Whatcom County. Moreover, according to the Health Department, the county had the second highest rate of treatment admissions for opioids in Washington State.
Of the 39 counties in the state, Whatcom County ranks third for overall negative impacts from heroin abuse and sixth for overall negative impacts from prescription opioids.
“The crisis has significantly strained county departments and services,” attorneys detailed in their complaint, “including through increased costs in the areas of public health, the county’s jail system, the county’s court and social service systems, and emergency medical services. Opioid addiction has caused a substantial increase in crime in Whatcom County, including property and retail crimes. The county also estimates that a large proportion of the county’s homeless population is addicted to heroin, which compounds the problem of homelessness and makes it more difficult for the county to address.”
Yet in light of the county’s ranking among other communities around the state in the incidence of opioid abuse, the complaints filed by the ACLU seem particularly damning.
Whatcom County’s policy and practice has been to to deny medically assisted treatment (MAT) for all inmates suffering addiction withdrawal, except for pregnant women, and only now—years into the epidemic—is beginning to slow walk the protocol to the wider jail population.
“The county’s Subutex protocol for pregnant women indicates that county understands that MAT is a safe, effective treatment for OUD,” the ACLU reasoned in their complaint. “It also indicates that the county has the means and resources, including trained staff and internal protocols, to provide Subutex to anyone with OUD.”
As the county prepares to clean house on the failings of the pharmaceutical industry, the county should also proceed to sweep their own front door.