Last Updated on December 27, 2021 by Dr. Alberto Solà

Oklahoma became the first state to bring a pharmaceutical company to court over opioid addiction on May 27th, and they are just one of forty-four different states currently planning to sue.

The opioid crisis is out of control across the United States by anyone’s standards. Every day, more than 130 people in our country die from an opioid overdose. While opioids are, in fact, very effective for pain, they are extremely addictive, and many people believe their development, introduction, and use has developed into an unstoppable epidemic that is much more curse than blessing.

About the Epidemic

The U.S. Department of Health and Human Services (HHS) has declared the opioid epidemic to be a public health crisis, and are making bold moves to stop or at least slow it. However, despite this, opioids remain legal due to their legitimate medical applications. In order to decrease and alleviate addiction to opioids, HHS has identified five major priorities in their battle. This government organization aims to combat the opioid crisis by improving access to treatment and recovery services, by promoting the use of overdose-reversing drugs, and by strengthening the publics understanding of the epidemic.  Further, they wish to provide support for cutting edge research on pain and addiction and to advance better practices for pain management so fewer doctors will need to prescribe opioids to begin with.

How Did This Happen?

When strong opiate-based pain medications were developed and subsequently marketed in the nineties, pharmaceutical representatives convinced doctors that these new drugs were a miracle. Not only would they effectively alleviate pain, but they were also not addictive.  These statements were made with little research to back them but, but doctors believed the salesmen and began to aggressively prescribe them in pain management situations.

Quickly it became evident that these medications were, in fact, highly addictive, but they continued to be prescribed. Fast forward to the present, and they have become a major problem in America, for people of all ages, races, backgrounds, socio-economic statuses, levels of education, and genders, from all walks of life and in all corners of the country. In 2017, an estimated 1.7 million people suffered from substance abuse disorders related to prescription opioid pain relievers.

Often these problems begin with a legitimate prescription for actual pain. According to the National Institute on Drug Abuse, 21-29% of the people who are prescribed opioids for chronic pain misuse them, and between 8-12% of users develop an opioid use disorder. Eventually, a patient needs more to get the same effects, and in some cases their doctors unsuccessfully try to wean them off their medication; as a result, 4-6% of those who misuse prescription opioids transition to heroin, and 80% of people who use heroin began by misusing prescription opioids.

So Now What?

So now, states are finally taking on the pharmaceutical companies and are fighting back. The Center for Disease Control (CDC) estimates that the total economic burden of prescription opioid misuse, abuse, and addiction in the United States is $78.5 billion per year. This includes the costs of health care, lost productivity, addiction treatment, and criminal justice involvement.  The states feel that they are spending a great deal of money to regulate and deal with the opioid epidemic, and that they have the right to recoup some of the costs from the companies that are profiting from the production of these drugs.

As of mid-May 2019, forty-four states have filed lawsuits against these companies. There are 2,000 cases total brought on this topic by state, local, and tribal governments. Oklahoma is simply the first one to bring it to an actual courtroom, and the results of this trial will likely set a precedent that will be followed in many of those later cases.

Although Oklahoma filed against numerous drug companies, many settled out of court by paying settlements to the state worth many millions of dollars. In one example, Teva Pharmaceutical, a company based in Israel, agreed to am $85 million payout instead of going to trial. Purdue Pharma, the maker of OxyContin, one of the most well-known and notorious opioids, settled with the state for $270 million.

Johnson & Johnson, however, decided to try their company’s luck in court. The lawsuit filed against them in Oklahoma alleged that the company was “the kingpin behind the worst man-made health crisis in the state’s history.”

It’s likely that this trial will go on for quite some time before any progress is made, but the state’s position is that Johnson & Johnson marketed opioids as a safe form of pain relief, when they knew that wasn’t actually the case, and with only profits in mind. Further, Johnson & Johnson manufactures a fentanyl patch that is used in extreme cases of pain; it is very attractive on the black market and has caused further and more immediate deaths.  The state argues that Johnson & Johnson created a public nuisance that will cost billions to remedy over the next several decades.

A Step in the Right Direction

Although it’s hard to predict the final results of this trial, it at least is a step in the right direction and is a start in the battle against the opioid epidemic in our country. It’s true that opioids have helped many people to alleviate chronic and unbearable pain, but they have also caused countless sadness, problems, and death. It’s unlikely these drugs will ever be outlawed due to the positive effects they have on many, so we instead need to focus on lessening the negative effects and the spread of addiction.  Money is needed for education and treatment and it seems only sensible that the pharmaceutical companies that not only created these drugs but that recklessly marketed them pay for at least some of that. Hopefully our nation will soon be able to get a handle on this epidemic and will save more lives.  Oklahoma is a pioneer in fighting back against the crisis and it will be interesting to see if they succeed in doing so. Certainly, if they do, many other entities will soon follow suit. 

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