Drug distributors are cleared of the opioid crisis in W. Va. County.

A federal judge has ruled that the nation’s three largest drug distributors cannot be held responsible for the opioid epidemic in one of the country’s most ravaged counties – a place where 81 million prescription painkillers have shipped in eight years to a population of less than 100,000. .

Judge David A. Faber of the U.S. District Court for the Southern District of West Virginia delivered his opinion on the July 4 holiday, nearly a year after the end of a lawsuit by the city of Huntington and the Cabell County, who were the focus of an Oscar-nominated documentary titled “Heroin(e)” about the effect of prescription painkillers.

The fatal overdose rate in Cabell County rose from 16.6 to 213.9 per 100,000 people, from 2001 to 2017, according to the ruling.

In exonerating the drug delivery companies – AmerisourceBergen, McKesson and Cardinal Health – Judge Faber acknowledged the terrible cost to the county and the city, but added that “although there is a natural tendency to blame in such cases, they must be decided not based on sympathy, but on facts and law.

His decision underscores the difficulty of determining responsibility for a decades-long disaster in which many entities played a role, including drugmakers, drugstore chains, physicians and federal oversight agencies, as well as distributors. of drugs.

Drug distributors typically fulfill pharmacy orders by trucking drugs from manufacturers to hospitals, clinics, and stores, and are responsible for managing their inventory. Like other companies in the drug supply chain, distributors are expected to comply with established federal limits for controlled substances like prescription opioids, and have an internal monitoring system to detect problematic orders. City and county attorneys argued that distributors should have investigated orders from pharmacies that requested addictive pills in quantities grossly disproportionate to the population of these small communities.

But Judge Faber ruled: “At best, distributors can detect increases in distributor orders that can be attributed to doctors who may intentionally or unintentionally violate medical standards. Distributors are also not pharmacists who are experts in assessing the red flags that may be present in a prescription.

The judge also strongly rejected the legal argument that the distributors had caused “public nuisance,” an allegation widely used in the national opioid litigation and which has so far had mixed results in a handful of cases. state and federal affairs.

The three distributors had finalized an agreement earlier this year to settle thousands of lawsuits brought by states and thousands of local governments, in which they agreed to pay $21 billion over 18 years for treatment and prevention services. drug addiction. But Cabell County and the city of Huntington, often described as ground zero for the crisis in the United States, refused to sign, believing they could get more money by going to court. They had requested more than $2 billion from the companies.

“The lawsuit is always a gamble, and this one hasn’t paid off,” said Elizabeth Burch, a professor at the University of Georgia School of Law who has followed the national opioid litigation closely.

At trial, county and city attorneys presented emails from AmerisourceBergen calling West Virginia “pillbillies” and referring to the area as “Oxycontinville.” A company executive said the samples were hand-picked and were just examples of employees expressing fatigue at work.

In a statement applauding the decision, Cardinal Health said it has a rigorous screening system in place. Distributors do not “manufacture, market or prescribe prescription drugs, but only provide a secure channel to deliver drugs of all kinds from manufacturers to our thousands of hospital and pharmacy customers who dispense them to their patients on the basis of medical prescriptions”.

AmerisourceBergen noted that pharmaceutical distributors “have been asked to walk a legal and ethical tightrope between accessing needed medicines and preventing the diversion of controlled substances.”

McKesson, in his statement, added, “We only dispense controlled substances, including opioids, to DEA-registered and state-licensed pharmacies” and argued that the diversion and abuse of drugs are a problem to be solved through a comprehensive approach involving private industry, government, providers and patients.

Steve Williams, Mayor of Huntington, who took office in 2012 as opioids devastated voters, said his disappointment with the decision could not be measured and called it “a blow to our city and our community, but we remain resilient even in the face of adversity.

Citizens, he said, “should not have to bear the primary responsibility for ensuring that an outbreak of this magnitude never happens again.”

Attorneys for Cabell and Huntington counties, along with a national executive committee of opioid plaintiffs, released a joint statement expressing their deep disappointment.

“We found that evidence from witness statements, company documents and extensive datasets showed that these defendants were responsible for creating and overseeing the infrastructure that flooded West Virginia with ‘opioids,’ they said. “Apart from the outcome, our gratitude goes to the first responders, officials, treatment professionals, researchers and many others who testified to bring the truth to light. ”

The county and city are considering appealing.

Although the gamble of pressing the case was risky, some other governments have been successful at trial. Washington state also refused to sign the national settlement, sued the distributors, and in May settled $46 million more than it would have received under the national settlement. In June, Oklahoma also settled with distributors more money than the national settlement would have offered.

The state of West Virginia had resolved its cases against the distributors years earlier for a total of $73 million, but local governments were free to pursue their own lawsuits. The outcome of this case, Ms Burch said, is “a cautionary tale of the surefire cash-out that a settlement offers.”

A new lawsuit in West Virginia against the same three distributors was scheduled to open in state court on Tuesday, brought by another group of West Virginia counties and cities, which are represented by the same attorneys who sued the matter decided on Monday. In court on Tuesday, however, the start date was postponed.

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