Nearly 64,000 Americans died of drug overdoses in 2016, and at least two-thirds of those deaths were linked to opioids, a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.
That means that more Americans die from drug overdoses than from car crashes, gun homicides and AIDS-related deaths combined.
While these deaths are increasingly linked to illicit opioids such as heroin and fentanyl, the rise in opioid misuse, addiction, and overdose originally began with the proliferation of prescription painkillers — which were flooded into cities and counties by profit-seeking pill manufacturers and distributors.
The ill-effects of opioid addiction and abuse have reached far beyond immediate painkiller users. For example - the number of babies born in Springfield with Neonatal Abstinence Syndrome (NAS), induced specifically by prenatal opioid use, has skyrocketed. Over 1,200 babies were born with NAS in Missouri in 2015 and 2016. One Springfield hospital fills at least one of its 28 Neonatal Intensive Care Unit rooms with an addicted baby each day.
The number of opioid-addicted infants born in Springfield surpasses that of any other city in the state.
The city continues to witness an increase in opioid overdoses. It is not unusual for local emergency responders to react to several each day. Although opioid overdose death rates were at 17.9 fatal overdoses per 100,000 people, in 2012, these local rates climbed to 31.6 per 100,000 in 2015. The overdose rate for Springfield citizens under the age of fifty years is almost twice the national average.
During the first six months of 2017, Springfield lost seven citizens to overdoses and Springfield Police seized 1,460.5 pounds of heroin. Greene County lost 22 people in the first nine months of 2017 from prescription opioid overdoses alone, and 23 more from illicit fentanyl and heroin overdoses.
“It is affecting almost every single man, woman and child within our community in some way,” said Springfield City Manager Greg Burris. “We have taken steps to help address the misuse of these opioids, such as the creation of a Prescription Drug Monitoring Program (PDMP) and the launch of a Task Force on Substance Abuse and Mental Health, but a challenge of this scale demands a multi-layered response.”
On May 24, City and County officials and community partners announced the Healthy Living Alliance’s formation of a Task Force on Substance Abuse and Mental Health. The charge of the multidisciplinary group includes developing a Springfield-Greene County community action plan and determining the estimated overall economic/fiscal impact that unaddressed substance abuse and mental health issues place on the community, how much that impact is likely to grow if we do nothing more than what is being done today, and community-wide savings that could result if we implement recommended strategies.
The City of Springfield and Greene County are now ready to take the additional bold steps that nearly 500 counties and 300 cities and towns have taken. Each will file an opioid-related lawsuit against opioid manufacturers and distributors.
The City plans to file its lawsuit in federal district court on May 30, 2018. The City’s lawsuit will likely be consolidated with lawsuits filed by other cities and counties around the country, for purposes of discovery and qualification of witnesses in what is called multidistrict litigation (MDL). Greene County is preparing to file a separate lawsuit.
“We want to do everything we can to address this crisis and a lawsuit of this nature will hopefully hold manufacturers and distributors more responsible,” said Greene County Commissioner Harold Bengsch. “In addition to this action, we will also continue to work closely with the newly formed Task Force on Substance Abuse and Mental Health to find solutions that further combat this issue and other addictive behaviors in our community.”
There are two principal legal arguments supporting these cases, one against opioid manufacturers and another primarily against opioid distributors.
Starting in the mid-1990s, opioid manufacturers unleashed a misleading marketing push underplaying the risks of opioid painkillers and exaggerating such drugs’ benefits. This constitutes false advertising with deadly consequences — by encouraging over-prescription and creating the unsubstantiated notion that opioids are good for chronic pain and not addictive. Direct-to-consumer advertising persuaded patients to believe the pills were safe and effective.
Meanwhile, opioid distributors supplied a large number of these drugs, even when were aware they were being distributed to people who were misusing the drugs. This claim is backed by data that shows that in some counties and states, there were more prescribed bottles of painkillers than there were people — some believe to be a sign that something was going very wrong. Federal laws require distributors to vigorously monitor the supply chain to ensure their products aren’t falling into the wrong hands. Letting these drugs proliferate violates those laws.
“Each defendant contributed to this crisis by flooding Springfield and other communities with excessive amounts of dangerous and addictive medications,” Burris said. “Defendants’ actions are a serious breach of the public trust, which has resulted in drug misuse and abuse, addiction, and deaths, and great expenses for Springfield, a first responder to the opioid epidemic.”
The City’s lawsuit details how distributor defendants knew, or should have known, that the millions of doses of highly addictive opioids they were shipping into Springfield were far in excess of the legitimate needs for Springfield and should have been stopped and/or reported to authorities as required by federal law, before such activities developed into the crisis the community now faces.
Though they had a duty to the consuming public, both collectively and individually, distributor defendants failed to take any action to effectively prevent, minimize, or reduce the distribution or availability of these dangerous drugs.
In addition, distributor defendants paid their sales force employees’ and managers’ bonuses and commissions based upon the sale of most, or all, of the highly addictive opioids supplied to Springfield. The result of these companies’ actions has been catastrophic for Springfield and its residents, while the companies themselves profited substantially from the opioids sold here.
The financial costs to Springfield include significant increases in expenditures on emergency services, including responding to overdose calls and crime reports that are the natural product of increased drug abuse. For example, the city added 21 police officers to its force and is seeking a grant to add seven new firefighters. The need for two additional fire stations has also been documented.
Costs to Springfield also include, but are not limited to: funding health insurance; providing medical treatment; investigating and prosecuting drug-related crimes; incarcerating perpetrators; supervising and rehabilitating the addicted; and preventing, investigating, and treating overdoses.
The prescribing and dispensing rates in Greene County are well above national and Missouri averages. In 2010, the estimated rate of opioid prescriptions per 100 U.S. residents was 81.2. The same rate per 100 persons in Missouri was 91. The rate was 143.8 in Greene County. That rate has remained high in Greene County, at 108.9 in 2016, despite the national rate decreasing to just 66.5, and the Missouri rate improving to 80.4. In 2015, Greene County had approximately 70% more opioids prescribed per capita than the national average.
“This is truly an epidemic that transcends all facets of our community,” said Greene County Commissioner Lincoln Hough. “It is a public health and safety concern for every member of our community. The recovery for individuals that find themselves addicted to these opioids can take decades and the strain on their families and our community is heart wrenching. As we move forward with this litigation it’s important to remember that this is about holding manufacturers of these drugs accountable and taking the necessary steps to ensure we protect our community from the continued spread of these drugs. I believe it would be hard to find a member of Springfield or Greene County that has not been impacted, or has known someone that has been impacted by these drugs. It’s time to get control on this epidemic for the good of all our families, friends, and neighbors.”
The current epidemic is proof of what we already knew: As drug companies saw their profits increase, so too did drug overdose deaths and addiction treatment admissions.
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