Ex-Suffolk ME said officials started workshops when opioid overdose deaths increased

A former Suffolk County medical examiner testified Thursday in a high-profile opioid epidemic trial that 2016 became a "landmark year" when heroin deaths in the county were surpassed by deaths from other opioids.

Dr. Michael Caplan told jurors at Touro College in Central Islip that deaths from fentanyl in Suffolk County jumped from 11 to 211 between 2010 and 2016, and then up to 300 in 2017.

Heroin deaths increased more than four times from 37 to 165 between in 2010 and 2015, he said, citing county government reports, but that was still less than fentanyl.

He said the opioid problem became so severe that he and other officials started giving workshops in local schools through programs with names such as "The Ugly Truth" and "The Pathway of Substance Abuse: A Road to Death."

Caplan was testifying in a trial in which New York State and Suffolk and Nassau counties are suing drug manufacturers and distributors for allegedly fueling an opioid epidemic over the last decade or so that killed several thousand Long Islanders, and even more throughout the country.

On Tuesday, some of the companies reached a $1.1 billion settlement with the state and counties that is part of a nationwide $26 billion settlement involving other states, counties and cities.

But the trial is continuing, with three remaining drug manufacturers — Allergan PLC, Teva Pharmaceutical Industries and Endo International — along with distributor Anda Pharmaceutical Products.

The New York opioid litigation is the first case of its kind in the nation to go before a jury. Other states are looking at it as a possible bellwether in litigation involving the opioid epidemic.

Lawyers for New York State and the counties say the defendants created a "public nuisance" by pushing the drugs that created the epidemic.

Attorneys for the drugmakers and distributors say their clients are not responsible for the epidemic. They argue that the companies followed all regulations and are being made scapegoats for the actions of health regulators who encouraged opioid use, doctors who overprescribed the painkillers and other forces beyond their control.

On Wednesday, a top official in the Nassau County Medical Examiner’s Office testified that when he first arrived in the county in 2009, police and prosecutors seemed unaware of the looming opioid epidemic.

But Dr. Joseph Avella, chief of toxicology, said that after he tried to bring to their attention what he was seeing in his office as cases of opioid overdose deaths rose sharply, officials responded.

Similar to Suffolk, the case numbers in Nassau were rising dramatically, he said.

"We began to see a number of fentanyl cases that we had never seen before. Fentanyl, we used to encounter it you know, say three, four, five times a year. We were now all of a sudden seeing fentanyl cases 50, 60, 70 times a year. Much, much greater frequency."

Caplan said Thursday that the rise in cases in Suffolk was mirroring a rise nationally, according to statistics from the U.S. Centers for Disease Control and Prevention, which were shown at the trial.

He said the workshops officials ran for students and parents tried to get past the misconception that drug addicts were typically impoverished people living on the streets.

Instead, he said, many addicts come from middle-, upper-middle or upper-class families.

"Sometimes people say, ‘Well that’s not me, that’s not my family,’ " Caplan said. But "maybe it could be your family."