With advancements in this era of modern medicine, there’s a pharmacological solution for many diseases. In some cases, however, the remedies can bring their own set of issues. Some prescription drugs like painkillers can lead to addiction, physical dependence, and a host of other problems. Examples of problematic prescription drugs are Opioids. These are a broad group of pain-relieving drugs that bind to opioid receptors to stop or reduce feelings of pain. They can be made from the poppy plant or synthesized in a laboratory. Opioids are typically prescribed to treat persistent or severe pain for individuals who have just undergone surgery or those who have been seriously injured in falls, sports, auto accidents, or other incidents.
Statistics show that the number of opioids sold in the American market has quadrupled since 1999, and so has the number of prescription opioid deaths. As reported by The New York Times, the rate of deaths caused by drug overdoses is rising faster than other causes of deaths. The spread of the opioid epidemic can be compared to the HIV/AIDS epidemic of the late 1980s and early 1990s.
Due to the adverse effects of opioids, many of the individuals who’ve developed addiction and areas ravaged by addiction are filing taking legal action against pharmacists, doctors, and drug wholesalers. The opioid mass tort action alleges that doctors, pharmaceutical companies, and “pill mills” got patients hooked on these medical products and cost people and the state at large millions of dollars in law enforcement, medical expenses, rehabilitation, and other expenses.
When opioids travel through the blood, they attach to proteins called opioid receptors on the brain cells. The opioid receptors belong to a family of proteins referred to as G protein-coupled receptors (GPCRs). Recent studies have found that G protein-coupled receptors can be activated within the cell and at the cell surface. When the drug attaches to the receptors, the cells release signals that muffle pain messages sent from the body through the spinal cord to the brain. This boosts a person’s feeling of pleasure.
Opioids are powerful prescription painkillers. Moreover, while they can effectively relieve pain, they carry some risks, especially when used to manage chronic pain over a long time. One study found that in addition to activating receptors, opioid drugs induced nanobody signaling in receptors in internal structures within ten seconds of consumption. This rapid and different way of interacting with receptors may help explain why opioids create their undesired effects.
Below are some of the most prescribed opioids:
While heroin is no longer prescribed by doctors, it carries the same side effects as the aforementioned drugs. When there was a crackdown on opioid prescriptions, most opioid addicts switched over to heroin in order to obtain a similar feeling- often with fatal outcomes.
These prescription drugs have a spotty record of pain management. A 2016 study published in Pain Reports found that opioids actually intensify chronic pain. On the other hand, the Centers for Disease Control and Prevention (CDC) discouraged physicians from recommending opioids because of the ever-present threat of overdose as well as their extremely addictive nature. In a report by The Washington Post, CDC noted that there is limited evidence that prescription opiates are effective in treating long-term pain.
According to the research reports by the CDC, FDA-approved abuse-deterrent formulations that have properties expected to reduce the likelihood of misuse may not be as heavily marketed as opioids. In fact, the reports show that the comprised of one-fifth of total payments to doctors. Moreover, despite the recommendations by the CDC to consider the use of non-opioid painkillers, non-steroidal, anti-inflammatory drugs were not aggressively marketed as opioids.
How the Opioid Epidemic Happened
If studies show that opioids are much more addictive than they are effective, how comes they were prescribed to millions of people? Well, to begin with, prescription opioids were mainly approved for short-term pain and chronic pain linked to cancer and the end of life. That was before the 1980s. However, the emergence of prescription narcotics was due to the medical community’s rethinking of pain the mid1980s. From a symptom that should be tolerated, the pain was later viewed as a critical symptom that physicians could measure and treat. The expanded pain pill use saw pharmaceutical companies jumping on the opportunity and introducing new pain medications and aggressively marketing them.
Purdue Pharma, the manufacturer of OxyContin, is one company that exemplified the industry’s concentration on non-cancer pain. The U.S. Food and Drug Administration (FDA) approved the use of OxyContin in 1995. Between 1996 and 2002, the OxyContin prescription increased from 300,000 to 7.2 million. The sales grew from $44 million to $1.5 billion over that period. The number of Purdue sales agents also grew dramatically. This growth was largely due to the company’s aggressive marketing tactics. Purdue spent $200 million on OxyContin marketing in 2001 alone. The drug manufacturer gave the sales representatives six-figure bonuses that year.
What’s more, the company compiled doctors who prescribed most drugs in its database and targeted them. Practitioners also received branded promotional materials, including plush toys, hats, coupons, and coffee mugs. Also, Purdue Pharma carried out “Pain Conferences” that targeted physicians with medical journal advertisements. Purdue’s marketing campaign claimed that OxyContin posed an addiction risk of less than 1%. This marketing frenzy was founded on a lie that would later prove deadly. Sales representatives assured some health practitioners that the drug was highly effective and did not even cause a buzz. The manufacturer introduced stronger drugs with higher risks for addiction and abuse.
Pharmaceutical Companies Benefitting from Pain
From as far back as the 1900s, the use of opioids was strictly limited to extremely narrow conditions like end-of-life care and post-surgical pain. That was due to the fact that medical regulators were aware of the dangers posed by the drugs. However, when a school of thought took the reins in medicine in the late 1990s and early 2000, everything changed. Pain became the “5th vital sign”. Treating it was a top priority, but the addiction was not more of a concern.
Drug manufacturers significantly contributed to this transformation and earned billions in return. As a result of this, states, counties, cities and other jurisdictions throughout the nation are fighting back with investigations and lawsuits with the hope of holding Big Pharma liable for the damages of the country’s opioid epidemic. The seeds of this crisis were sown two decades ago. The medical establishment started prescribing opioids for chronic pain with little or no evidence to support its use.
The ratings of medical facilities and physicians were even determined by how well they reduced patients’ pain. To make matters worse, physicians started treating patients with some signs of addiction by providing them with more opioids. According to the Centers for Disease Control and Prevention, the number of prescription opioids sold almost quadrupled between 1999 and 2014, but there was no evidence of a change in the overall pain reported by Americans.
According to government numbers, the number of opioid prescriptions given in 2012 peaked at 81.3 prescriptions for every 100 individuals or more than 255 million in the U.S. alone. The data also shows that over 650,000 opioid prescriptions are dispensed each day in the United States. By 2014, the U.S. had consumed about 80% of the global opioid supply, making it a $24 billion market.
Doctors Received Millions in Opioid Campaign
A 2016 study revealed that doctors received more than $46 million in payments from drug manufacturers promoting prescriptions opioids in a 29-month period. About 50% of these payments involved fentanyl, a synthetic opioid that is 50 to 100 times stronger than morphine. National data shows that fentanyl is a major player in the growing number of overdose deaths, although most of the deaths are as a result of illegal fentanyl.
In the 29-month period study, about 12 doctors in the United States obtained a payment from a drugmaker linked to opioids. The value of payments made to doctors went up by 11 percent from 2014 to 2015. The study authors wrote that the payments may have obstructed national efforts to reduce overprescribing. The average paid per doctor was $15, though the top 1% of the doctors received 82.5% of total payments in dollars. The author of the study noted that preceding research found that even small gifts offered to physicians make the health practitioners much more likely to prescribe the specific drug that’s being promoted.
Another study by researchers at the University of California found that doctors who were offered free meals were 3 times as likely to prescribe the manufacturer’s brand of drug. In addition, Big Pharma paid a total of $8.18 billion to physicians and teaching hospitals in 2016 alone. This translated to a 1.1% increase from 2015, according to the Open Payments Program.
How Addiction Compares to Abuse
Drug abuse refers to the use of a substance or medication for non-medical purposes. The abuse of prescription drugs, on the other hand, is defined as the use of prescription medications in a manner, other than as prescribed, to experience alternative feelings. More than 50 million individuals in American above 12 years admit to using a prescription drug for non-medical reasons once or more during their lifetime, and it’s the 3rd most abused substance, after Marijuana and alcohol. Prescription drugs can be abused by the actual patient or others who can access the medication.
Addiction to prescription medications can occur if the drug isn’t taken as prescribed or even when the drug used as instructed. Drugs such as opioids make changes in the brain, affecting how the Central Nervous System (CNS) functions. As such, the CNS is left unable to function normally without the drug. This refers to as dependence. Some statistics show that about 14% of individuals who abuse drugs become addicted or dependent on them.
Side Effects of Prescription Drug Addiction
Drug addiction may be physical and/or psychological. Psychological addiction occurs when an individual develops “cravings” for a medication he/she has been taking on a regular basis. Conversely, a person develops a physical addiction to a drug when he/she becomes tolerant of the substance. With time, the person will need more and more medication to attain a similar effect. A person can become physically dependent on a prescription drug even if he/she is using it as intended. For instance, long-term use of opioids alters the brain, making it dependent on the drug in order to function normally.
An opioid overdose is a devastating but common occurrence of opioid abuse. An overdose occurs when a person takes too much of a substance at a given time or by combining several substances. Individuals can overdose on opioids alone, though the risk is much greater for those who combine the painkillers with other substances at the same time.
The telltale signs of an opioid overdose include:
- Intermittent loss of consciousness
- Shallow or restricted breathing
- Constricted pupils
- Frequent vomiting
- Extreme sleepiness or inability to wake up
Many opioid addicts are encouraged to seek treatment after surviving an overdose. Nonetheless, some individuals are hesitant when it comes to rehabilitation. In fact, it’s common for people to wake up from an overdose and immediately use the drug again.
An individual who becomes dependent on opioid painkillers will experience uncomfortable symptoms is that they stop taking the drug or reduce the amount they were taking. This occurs as the body tries to adjust to functioning normally without the substance. Symptoms of opioid painkiller withdrawal on various factors, including the type of drug being used, an individual’s established tolerance to the drug, the length, and severity of the addiction, their mental and medical history, and whether they abuse other substances as well. Other factors include an individual’s current health and well-being, how they administered the drug, any underlying mental or behavioral disorders, and whether the family has a history of drug dependence.
The most common symptoms of opioid withdrawal are flu-like, such as vomiting, fever, and sweating. Others include anxiety, runny nose, agitation, abdominal cramps, muscle spasms, stomachaches, insomnia, diarrhea, nausea, tremors, constricted pupils, and fluctuating blood pressure. While these symptoms are not life-threatening, they can lead to extreme physical and psychological distress to a person. Moreover, since the withdrawal symptoms are usually intense, individuals trying to quit their use may end up using again to avoid the symptoms. However, continuous use can make it much more difficult to quit later on because symptoms intensify with time.
There are four phases of opiate withdrawal:
- Early acute
- Fully developed acute, and
- Withdrawal syndrome(PAWS)
Depending on a person’s level of addiction, withdrawal can occur a few hours after a person’s last dose. Once withdrawal passes, the person will be in a protracted abstinence period, which can last for several months. This period is when individuals are susceptible to triggers that can cause them to use again.
Thousands of Deaths Caused by Opioid Epidemic
The National Institute on Drug Abuse refers to the misuse and addiction to opioids a “serious national health crisis.” The U.S. Government declared the opioid crisis a public health emergency on October 16, 2017. According to government statistics, more than 90 people die every day due to opioid overdose in the U.S. The data also shows that over 28,000 Americans died after overdosing on opioids in 2014. This accounted for 61% of all deaths caused by drug overdose that year. The number of fatalities rose to 33,000 in 2015.
Reports show that in 2014, prescription opioids were abused by 10.3 million Americans. What’s more, there was a 153 percent increase in emergency room visits involving opioid abuse between 2004 and 2011. Conversely, substance abuse treatment programs increased 4 times between 2000 and 2012. While evidence suggests that the epidemic may be leveling off, a review published in the New England Journal of Medicine suggested that some individuals may be using pharmacologically similar heroin when they are unable to obtain prescription opioids.
An analysis of 2017 mortality figures by the National Safety Council show that the risk of dying from an opioid overdose if greater than the risk of dying in a traffic accident. Opioid overdoses are also higher than drowning, fire, and slip and fall incidents as causes of unintentional deaths. Moreover, only 13 states are actually making progress in managing the crisis.
Another study published in the journal Pediatrics states that the epidemic has greatly affected children and young people. The report reveals that between 1999 and 2016, nearly 9,000 children and adolescents died from causes associated with opioids. From 2004 to 2015, hospital admissions as a result of opioid overdoses among pediatric patients increased twofold. In general, however, 2017 was the deadliest year, with the number of opioid overdose deaths number exceeding 70,000. Most of these deaths have been linked to fentanyl, which is a very strong synthetic opioid, most of which have been illegally manufactured and smuggled into the United States from China.
Mass Tort Lawsuits Involving Opioids
Endo, Purdue, Jansen and other opioid manufacturers and distributors are facing several mass torts and dozens of lawsuits pending in state and federal courts. In December 2017, all the prescription opioid lawsuits filed in federal courts across the country were consolidated Judge Dan Polster in the Northern District of Ohio. Judge Polster was selected for the MDL for several reasons; Ohio has been greatly affected by the crisis and is also centrally located to the defendants. In 2012, there were 793 million doses of opioids dispensed in Ohio, making it one of the areas hit hardest by the epidemic.
The type of litigation is inherently unconventional, but opioid mass torts may be even more intricate than most. Instead of the cases being against one kind of industry defendant, it involves several, each playing a different role. The defendants could blame another, which could make the allotment of accountability more contentious. For instance, drug manufacturers, distributors, and retailers claim that drugs were approved by the FDA and prescribed by doctors.
Plaintiffs, on the other hand, allege that:
- Opioid manufacturers, such as Johnson & Johnson and Purdue Pharma, downplayed the risks of opioids and aggressively marketed them for several years even though they were aware of the addictive properties.
- Distributors, like Cardinal Health, AmerisourceBergen and McKesson (which together allegedly distributed more than 80% of opioids), shipped flag-raising quantities of prescription opioids without reporting to the authorities. Also, distributors failed to investigate, detect, monitor, and report suspicious orders of prescription opioids.
- Pharmacy chains such as CVS Health and Walgreens sold alarming amounts of the drug to individuals.
- Doctors, who are identified as “key opinion leaders,” received payments from manufacturers to prescribe opioids.
The plaintiffs allege that the defendants had an obligation to prevent diversion of opioids but failed to follow the required standards. This failure led to excessive use of the drugs and the subsequent opioid crisis.
Government Opioid Lawsuits
Hundreds of governmental bodies have sued manufacturers and wholesale distributors of opioids seeking restitution for government spending associated with opioid overdoses addictions and overdoses. Defendants in these cases include companies like Janssen Pharmaceuticals, Purdue Pharma, Endo International, Allergan, Teva Pharmaceutical, Covidien, and Watson Pharmaceuticals.
The complaints allege that opioid manufacturers exaggerated the benefits of the drugs and knew that doctors were overly prescribing the drugs, yet they failed to warn doctors of the drugs’ extremely addictive nature and the need to limit the dose strictly. The claims against the wholesale distributors are based on allegations that they violated the Federal Controlled Substance Act by failing to notify the U.S Enforcement Administration of suspicious purchases of opioid medication, such as orders of unusual size, pattern, or frequency. The complaints allege that this failure led to the excessive use of drugs and the subsequent opioid crisis.
These lawsuits also allege that the drug companies lobbied doctors and politicians in an effort to promote the use of opioids theatrically, and deliberately allowed the drugs to enter the black market. Claims against Purdue Pharma, in particular, include claims of fraud and knowingly encouraging addiction. In 2007, Purdue pleaded guilty to the crime of misbranding OxyContin with the intention of misleading and defrauding the public. The company paid off $635 million in fine.
Find an Opioids Mass Tort Near Me
If you or a loved one received a doctor’s prescription for opioid, developed drug dependency, suffered significant income loss, or suffered serious injury or death, it’s important to seek justice right away. The opioid lawsuit experts at Consumer Alert Now are prepared to help you understand the extent of the opioid epidemic and are prepared to help you navigate the complex legal climate. The defendants in these cases are powerful and resourceful, but we can connect you to nationwide attorneys who will effectively represent you in a mass tort. Contact us today at 800-511-0747 to schedule a consultation.