Ohio’s lawsuit against drug companies: What’s really going on?

The suit alleges that the companies spent millions of dollars to deceptively market drugs to doctors and patients in Ohio, leading to a devastating opioid addiction crisis which appears to have not peaked.

It seeks an injunction, damages for the state and repayment for consumers. The state says it has shouldered an enormous burden treating addiction, including care for babies born with Neonatal Abstinence Syndrome, as well as borne the financial toll heaped on law enforcement due to the epidemic.

• Purdue Pharma

• Endo Health Solutions

• Teva Pharmaceutical Industries and its subsidiary Cephalon

• Johnson & Johnson and its subsidiary Janssen Pharmaceuticals

• Allergan

• Violated the Ohio Product Liability Act by creating a condition harmful to the health of Ohioans.

• Created a public nuisance by contributing to a condition harmful to the health of Ohioans or interfered with the comfortable enjoyment of life in violation of Ohio law.

• Broke the Consumer Sales Practices Act by misleading consumers about the products they were taking.

• Engaged in Medicaid fraud by misleading the state to receive reimbursements.

Janssen said the allegations in the lawsuit are legally and factually unfounded and the company has acted responsibly and in the best interest of patients.

Purdue Pharma said the company shares the Ohio attorney general’s concerns about the opioid crisis and is committed to working together on solutions. Purdue Pharma said its OxyContin accounts for less than 2 percent of the opioid painkiller market and the company supports prescription monitoring programs and access to Naloxone, which reverses an overdose.

Teva, Endo and Allergan declined comment.

Many Ohioans became addicted to pain medications prescribed for legitimate reasons. Others sought the drugs for recreational use. The drugs were often easily attainable by “doctor shopping,” or through pain management clinics, the most aggressive so-called “pill-mills.”

By 2007, more Ohioans were dying of unintentional drug overdoses each year than in auto accidents.

The state began taking steps around 2011 to crack down on doctors who recklessly prescribed medications, including opioids.

Since, prescribing guidelines have been tightened and a computerized monitoring system put in place to track the type and amount of medications prescribed to Ohioans.

As prescription pills became less available, those already hooked  — as well as those with new addictions — are served by the black market. But due to some of the controls, pills diverted to the street are expensive and many seek a cheaper alternative and turn to heroin, which has a similar effect on brain and body but comes at a higher risk.

Going back years, users could only guess at the potency of heroin they were taking, but the risk has risen enormously since 2014. Today, the product on the street is more likely to be partially or entirely fentanyl, the extremely powerful opioid greatly responsible for the current tide of overdose deaths.

According to the Ohio Department of Health, 21,003 people in the state have died from unintentional drug overdoses in the past 10 years. Many counties, including Montgomery and Miami, surpassed last year’s record number of overdose deaths just five months into 2017.

Connecticut, West Virginia, Kentucky, Mississippi, cities and counties have filed lawsuits over the past several years, arguing that the drug makers and distributors irresponsibly marketed the products and encouraged over prescribing. DeWine said Ohio and Mississippi are the only states that have filed direct lawsuits challenging marketing by drug manufacturers.

Tobacco companies faced a similar legal strategy decades ago when states won a $113 billion settlement by arguing the industry purposely hid the addictive and harmful effects of cigarettes.