The pharmaceutical industry’s misleading campaign to promote opioids as safe and effective was so successful that many regulatory bodies and medical organizations embraced it — with devastating consequences for many Long Island families, a Stanford University addiction expert testified Wednesday in Central Islip.
The FDA, Centers for Disease Control and Prevention, American Medical Association and other organizations have reversed course in recent years, Stanford psychiatry professor Anna Lembke said. But she said many health care providers continue to believe the risks of opioids are minimal — even after thousands of Americans have died from overdoses.
"Medicine is a very slow-turning ship, and once these promotional messages changed the opioid-prescribing paradigm, it has been difficult to unwind those messages," Lembke said under redirect examination by Jayne Conroy, an attorney representing Suffolk County.
Lembke spent this week testifying for Suffolk, Nassau and New York Attorney General Letitia James in a class-action lawsuit filed in state Supreme Court that alleges drug manufacturers and distributors created a public nuisance by misleading physicians and patients with promotional messages that minimized the dangers and addiction risks of opioids.
State and county officials say they hope to hold the defendants — three pharmaceutical manufacturers, four distributors and their subsidiaries — accountable for the death and misery caused by the opioid epidemic and to recoup millions of dollars for treatment, recovery and prevention.
Lembke had testified earlier in the landmark trial that the defendants and other pharmaceutical companies had used misleading messages to convince doctors and patients that opioid pain medication was safe and effective
Lembke concluded her testimony on Wednesday, several hours after the CDC announced that more than 93,000 people died from drug overdoses in 2020, the highest number ever recorded. That was almost 30% higher than the 72,000 deaths projected for 2019, the CDC said.
Projected fatal drug overdoses jumped 34% in Nassau last year and nearly 12% in Suffolk, Newsday reported in April. Federal and Long Island officials say the majority of the deaths were caused by opioid abuse, which surged as a result of social isolation and mental health challenges during the coronavirus pandemic.
Attorneys for the drugmakers and distributors have said their clients are not responsible for the opioid epidemic, arguing they 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.
Defendants in the case are Teva Pharmaceuticals, Endo Pharmaceuticals, Allegan Finance, Cardinal Health, McKesson Corp., Amerisource Bergen and ANDA Inc.
Under redirect examination from Hunter Shkolnik, an attorney for Nassau County, Lembke testified that opioid companies funded flawed studies conducted by their own employees and consultants to "infiltrate" medical education. Those studies were embraced by the medical establishment for a time despite faulty methodologies, according to Lembke, a physician who treats patients struggling with substance abuse.
Lembke said researchers, including those who published an article in the Journal of the American Medical Association in 2018, were forced to conduct studies to counter the pharmaceutical companies’ opioid promotions. Those studies found that opioids were not effective for the long-term treatment of moderate to severe pain, and that the risk of addiction had been understated.
"There was no evidence to support the misleading statements that certain opioid manufacturers made that contributed to the paradigm shift in opioid prescribing," Lembke said. "But because the narrative became so entrenched in medicine, it became necessary to actually do the studies to prove that false narrative wrong because people had come to believe it."
Earlier in the day, Allegan attorney Mike Brock attempted to portray Lembke as a highly paid gun for hire who has profited handsomely as an expert witness. Lembke, who testified earlier that she is paid $500 an hour for research and $800 an hour to appear on the witness stand, testified last week that addiction medicine is considered a low-prestige, poorly compensated field.
Brock said Lembke has made hundreds of thousands of dollars as an expert witness in litigation in Ohio, California and West Virginia, as well as New York.
"You have made a lot of money, a lot of money, testifying in this litigation about these issues, correct?" Brock asked Lembke.
The landmark opioid litigation before state Supreme Court Justice Jerry Garguilo is being held at Touro College in Central Islip to accommodate the large number of attorneys involved in the case.
It is the first opioid lawsuit in the nation to go before a jury, which is expected to hear from hundreds of witnesses.