Why it’s so hard to break an opioid addiction
Florida Attorney General Pam Bondi has named the nation’s two largest pharmacy chains in the state’s massive opioid lawsuit, accusing Walgreens and CVS of racketeering in their “relentless campaign” to supply Floridians with opioids.
The two pharmacy giants, which have more than 1,500 locations between them across the state, broke Florida law by ignoring suspicious orders “all while claiming misleadingly to the public that they were fulfilling their duties as pharmacists,” Bondi’s lawyers say.
“Walgreens and CVS joined the race to sell as many opioids as possible, including by failing to institute safeguards and by marketing opioids to their vast networks of retail pharmacy stores and in-store pharmacists,” her lawyers wrote.
The claims are part of an amended complaint Bondi and her lawyers filed last week against the opioid makers and distributors that they claim created the nation’s opioid crisis, which has killed more than 10,000 people in Florida.
In addition to Walgreens and CVS, Bondi added Insys Therapeutics to the list of defendants. One of that company’s former executives pleaded guilty in federal court in Boston on Wednesday to conspiring to bribe doctors to prescribe the drug Subsys, a pain-relieving spray that contains Fentanyl, which is 80 to 100 times more powerful than morphine.
“The attorney general’s complaint pertains to allegations of past misdeeds by former employees,” Insys spokesman Joseph McGrath said Thursday, adding that the company is under new management and is “committed to a culture of compliance, ethics and integrity.”
Walgreens declined to comment. CVS did not respond to a request for comment.
In suing Walgreens and CVS, Florida’s attorney general joins counterparts in several other states, plus more than a thousand cities and counties across the country, that have taken the nation’s largest companies to court to try to recoup the costs of the opioid epidemic.
That includes the city of Clearwater, which earlier this month sued many of the same companies Bondi has sued, including Walgreens. The city of Tampa and Hillsborough and Pinellas counties have also filed lawsuits.
Lawyers for the city of Clearwater say its workers compensation and employee healthcare plans have shelled out nearly $200,000 on opioid prescriptions alone over the past six years, and it has spent $71,841 in grants to a facility that treats city residents for addiction.
That’s on top of the human cost. Between 2014 and 2016 alone, 643 people in Pinellas County died from opioid-related causes.
“There are repercussions from the opioid issue that we do have to deal with,” Clearwater City Attorney Pam Akin said. “It’s important for us to protect our position and potentially recover some of those costs.”
Clearwater’s legal team is working on contingency and will be paid only if the city receives a ruling in its favor, Akin said. The team would receive 20 percent of any judgment and 25 percent if it goes to trial.
Bondi’s lawsuit could reap billions for the state.
Between 1999 and 2016, more than 200,000 people nationwide died from overdoses related to prescription opioids, including thousands of Floridians, according to Bondi’s lawyers. Opioids killed nearly 6,000 people in the state in 2016, their complaint states.
Florida continues to suffer “massive losses” from opioids, her lawyers say, including from medical, unemployment and law enforcement costs, and from lost productivity and tax revenue.
In May, she sued some of the nation’s largest drug makers and distributors, including Purdue Pharma, the creator of the opioids OxyContin and Dilaudid; Endo Pharmaceuticals, which makes the drugs Percocet and Opana; and Johnson & Johnson and some of its subsidiaries, which make the drugs Duragesic and Tapentadol.
Last week’s amended complaint adds new details about what her lawyers describe as an elaborate, decades-long scheme to ship billions of opioids to Floridians.
Lawyers note in particular how the companies paid influential pain management doctors and funded chronic pain organizations in order to spread “misinformation” about opioids.
The companies gave millions to organizations like the American Pain Foundation, for example, which described itself as “the largest advocacy organization for people with pain.”
Although it described itself as an independent nonprofit, 88 percent of the group’s funding came from drug makers, and it spread misinformation about the risks of opioid addiction before shutting down in 2012, according to the complaint.
Cephalon, an opioid maker, relied on such front organizations to gain a foothold into the drug market. The company cited a study authored by Dr. Russell Portenoy, an influential pain doctor, and co-authored by several doctors on Cephalon’s speakers’ bureau, lawyers wrote.
Portenoy, who is not a defendant in Florida’s lawsuit, did not respond to a request for comment. But in 2012, he told the Wall Street Journal that he was having second thoughts about what he’d said about the drugs.
“Did I teach about pain management, specifically about opioid therapy, in a way that reflects misinformation? Well, against the standards of 2012, I guess I did,” Portenoy told the paper. “We didn’t know then what we know now.”
The drug distributors also “turned a blind eye” to the sheer number of opioids and suspicious orders throughout the state, lawyers allege.
The distributors paid data miners for “highly detailed data on opioid prescribing, sales, and distribution” — including data from other companies — that showed the massive amount of pills being shipped to, and prescribed in, Florida.
A single pharmacy in Hudson, with a population of 34,000, bought 2.2 million opioids in 2011 alone, for example.
Florida law requires distributors to note such suspicious actions, but none of the companies named in the lawsuit notified any law enforcement or regulatory body in Florida about them, according to Bondi’s lawyers.
“Defendants knew that widespread diversion of opioids was occurring in Florida, but turned a blind eye in order to earn higher profits,” the lawyers state.