The city of Chicago has filed a scathing 126-page lawsuit against five major pharmaceutical companies that it says are directly responsible for the dramatic rise in America’s addiction to opiate drugs. The suit alleges ten counts of fraud, conspiracy, unjust enrichment, insurance fraud, misrepresentation in advertising, and other violations of Chicago municipal code.
Chicago’s action against Johnson & Johnson, Purdue Pharma, Teva Pharmaceutical Industries, Endo Health, and Actavis echoes a California lawsuit filed two weeks ago. Santa Clara and Orange County sued the same companies on three violations of California business and civil code: false advertising, unfair competition, and public nuisance. Both lawsuits refer to a nationwide epidemic and contain similar language.
The lawsuits accuse the companies of engaging in a 20-year-long conspiracy to increase sales of highly addictive opiates by endorsing, creating, and distributing misleading medical education materials, supporting “front groups” to publicize biased literature and studies, and essentially buying the opinions of respected doctors in order to manipulate medical opinion and promote the prescription of these drugs. The suits noted that the companies focused particularly on veterans, among whom prescription drug abuse has spiked precipitously in the past decade. Chicago’s suit also alleges that the companies defrauded the city by getting its health plans and other insurers to pay millions of dollars for the unnecessary use of opioids.
“In order to expand the market for opioids and realize blockbuster profits, Defendants needed to create a sea-change in medical and public perception that would permit the use of opioids for long periods of time to treat more common aches and pains, like lower back pain, arthritis, and headaches,” Chicago’s complaint states. “Defendants, through a common, sophisticated, and deeply deceptive marketing campaign that continues to the present, set out to, and did, reverse the popular and medical understanding of opioids.”
According to the Centers for Disease Control and Prevention (CDC), prescription opioid sales — which were once prescribed almost solely to cancer patients for extreme pain — have gone up 300 percent since 1999. In a corresponding span of time, drug overdose deaths have more than tripled. Prescription opioids such as Vicodin and OxyContin now result in more overdose deaths in the US than heroin and cocaine combined.
“For years, big pharma has deceived the public about the true risks and benefits of highly potent and highly addictive painkillers in order to expand their customer base and increase their bottom line,” Chicago Mayor Rahm Emanuel announced in a press release. “This has led to a dramatic rise in drug addiction, overdose and diversion in communities across the nation, and Chicago is not immune to this epidemic.”
Chicago’s lawsuit offers damning evidence that the drug makers worked hard to distort medical research and clinical trials that documented their addictive properties and diminishing effectiveness over time. Long-term use can even increase sensitivity to pain, with chronic non-cancer pain users needing doses that doctors have described as “frighteningly high.”
“Although the drug manufacturers themselves don’t write prescriptions to patients, their deceptive marketing has caused doctors to more frequently prescribe their drugs, boosting sales and profits at the expense of patients,” Chicago spokesperson Shannon Breymaier told VICE News.
The city’s lawsuit refers to shady links between specific doctors, organizations, and opioid manufacturers, but targets only the drug manufacturers.
The lawsuits come two years after the Senate Finance Committee examined suspicious connections between these companies and doctors, medical groups, and patients’ associations that strongly advocated the use of opioids. Spurred by a muckraking ProPublica article, the Senate committee’s investigation looked into opiate-championing groups like the American Pain Foundation to determine how much of their funding came from the manufacturers of the very drugs it recommended.
Just as the committee began its investigation, the American Pain Foundation abruptly closed down, citing “irreparable economic circumstances.” ProPublica found that 90 percent of the foundation’s $5 million in 2010 funding had come directly from drug companies. Chicago cited the American Pain Foundation as the most prominent of the front groups financed by the drug companies to mislead the public.
The complaint notes that, rather than displacing heroin, the abuse of prescription painkillers has actually “triggered a resurgence in its use, which has imposed additional burdens on the City and local agencies that address heroin use and addiction. Chicago ranks first in the nation in heroin overdose deaths.”
Dr. Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, told VICE News that there’s no distinction to be made between prescription narcotics and heroin.
"It’s not a gateway drug, because it’s the same drug. One is a pill you get prescribed from a man in a white coat, the other is a powder you buy on the street, but it’s essentially the same drug,” Kolodny said.
“Younger people are going to heroin because in general if you’re 25 years old and young and healthy, doctors aren’t going to be as likely to prescribe quantities large enough to support your habit,” he added. “That’s the group that’s switching over to heroin.”
The CDC found that more than three out of four people abusing prescription opioids are using drugs prescribed for someone else.
“Young people are inherently curious about experimenting with drugs,” Kolodny said. “When they take a pill from mom’s medicine chest, they probably have no idea they’re taking a heroin pill.”
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