Opioid distributors: Health care system encouraged painkiller use

New York and federal officials urged physicians to increase opioid prescriptions to treat pain in the 1990s and 2000s, according to attorneys for pharmaceutical distributors who argue it is unfair for the state to now hold the companies responsible for overdose deaths that have devastated Long Island communities.

Distributors who simply filled orders to meet surging demand have become scapegoats for evolving health care industry standards, the lawyers said Thursday in opening arguments in the jury trial of the landmark lawsuit filed by Suffolk, Nassau and New York Attorney General Letitia James.

"The evidence is going to show that the entire health care system — the FDA, the DEA, the state of New York — encouraged doctors to treat pain, to prescribe these medications," said Steve Pyser, an attorney representing medical supply distributor Cardinal Health in the trial at Touro College in Central Islip.

The lawsuit filed in New York State Supreme Court alleges drug manufacturers and distributors created a public nuisance by misleading physicians and patients with marketing that minimized the dangers and addiction risks of opioids. State and county officials say they hope to hold the companies accountable for the death and misery caused by the opioid epidemic, and to recoup hundreds of millions of dollars for treatment, recovery and prevention.

Defense attorneys wrapped up their opening statements Thursday, and witnesses for the state and county will begin testifying Wednesday. The first witness to be called will be Dr. David Courtwright, a University of North Florida professor who is an expert in drug history.

Attorneys for the drug distributors said doctors boosted demand for the powerful painkillers by writing more prescriptions for the drugs, while the U.S. Drug Enforcement Administration increased supply by raising annual quota levels for national opioid production for years. The result, they said, was the opioid epidemic that has claimed thousands of lives on Long Island and nearly a half million across the nation.

Earlier investigations into the opioid epidemic by Suffolk and Nassau failed to find evidence that distributors were responsible for the crisis, the distributors’ lawyers said. A 2012 Nassau County report on prescription drug abuse did not cite evidence that the pharmaceutical distributor AmerisourceBergen played a role in the epidemic, said Mike Salimbene, an attorney for the company.

"My client did not cause the opioid crisis," Salimbene said.

A Suffolk County grand jury report on the diversion of prescription drugs, also from 2012, did not cite distributors either, Salimbene said.

New York state officials, meanwhile, placed the blame for the opioid crisis on OxyContin manufacturer Purdue Pharma in a 2018 lawsuit, Salimbene said. Purdue has filed for bankruptcy and is not a defendant in this trial.

The New York opioid litigation is the first case of its kind in the nation to go before a jury, which is expected to hear from hundreds of witnesses over months.

The distributors named as defendants in the lawsuit also said that they supplied just a tiny fraction of the opioid dosages shipped to Nassau and Suffolk in recent years. Attorney Jim Matthews, representing the distributor ANDA, said the company has filled just two orders in Nassau and two in Suffolk during the first six months of this year. ANDA has been named as a defendant by the counties but not the state.

Lawyers for the state and counties say they will prove that the defendants, which include pharmaceutical manufacturers Teva Pharmaceuticals, Allergan Inc. and Endo International, as well as distributors Cardinal Health, McKesson Corp. and AmerisourceBergen, created a "public nuisance" by pushing the drugs that created the opioid epidemic that has devastated Long Island families and communities.

If the plaintiffs prevail, a second trial will be held to determine damages that James said Tuesday should be dedicated to drug treatment, prevention and recovery support.

The lawsuit could set a template for a future national settlement with drug manufacturers and distributors, according to officials.

There are seven drug manufacturers and distributors, as well as their subsidiaries, named as defendants in the trial before New York State Supreme Court Justice Jerry Garguilo. It is being held at Touro College’s Jacob D. Fuchsberg Law Center, rather than the nearby Cohalan Complex, to accommodate the large number of lawyers and staff involved in the case.