Local governments across the land can find plenty of reasons to go after the drug industry over the crisis of opioid addiction.
Hillsborough County can find more reasons than most.
• In 2016, the county led the state with 579 babies born addicted to drugs.
• Through a unique, tax-supported health plan, Hillsborough provides health coverage to poor people who don’t qualify for it through plans such as Medicare and Medicaid. The plan is incurring inordinately high costs for treating people with opioid addictions.
• The U.S. Department of Justice has recognized the Middle District of Florida centered in Hillsborough as an opioid "hot spot" and assigned one of 12 prosecutors here to focus on opiate-related health care fraud.
• Contributing to this special federal status: One of the nation’s most notorious pill mills, First Medical Group, operated on North Dale Mabry Highway through 2010. Pills were resold nationwide at up to $80 apiece. By some analyses, 30 people died from overdoses or other causes traced to the clinic.
So local leaders are to be commended for taking a leadership role in filing a lawsuit Monday against a long list of drug makers and distributors, from Purdue Pharma to CVS and Walgreens, saying the companies embarked on a well-funded marketing scheme rooted in false and deceptive statements about the risks and benefits of long-term opioid use.
The lawsuit contains the disturbing boilerplate language found in a growing number of legal actions filed by the local governments who are bearing the brunt of the opioid crisis. But the lawsuit also notes the elevated stake Hillsborough has in holding accountable those who caused the crisis.
On Monday, local leaders announced the lawsuit as they stood with attorney Mike Moore, former Mississippi attorney general and a main figure in the wave of ongoing opioid lawsuits and before them, the lawsuits that brought the tobacco industry to account.
The announcements came in a week when the federal Centers for Disease Control and Prevention released a new report on another annual rise in deaths from opioids and when President Donald Trump — criticized for declaring a national crisis without providing resources to tackle it — urged the Justice Department to sue manufacturers.
What remains to be seen is how the courts will deal with a potential federal suit, on top of some 1,000 separate lawsuits by local governments and more by nearly every state attorney general. Also in question is whether a solution lies in legal action or in the work now under way by legislative bodies at the state and national level. Florida this year implemented strict new limits on the length of opioid prescriptions.
For now, the best answer may be: Try anything.
Drug overdoses killed about 72,000 Americans last year, the CDC reported — a record number that reflects a rise of about 10 percent and a higher yearly death total, the New York Times notes, than peak yearly totals from HIV, car crashes or gun deaths. The agency also reported this month that the number of children born in hospitals addicted to opioids grew fourfold from 1999 to 2014.
The role of the drug industry is difficult to deny. Addiction has tracked closely with a rise in the rate of prescriptions, the CDC notes, and the rate of prescriptions tracks closely with the marketing push by the industry.
It’s hard to remember, as the Hillsborough lawsuit notes, that before the 1990s opioids were prescribed only for the most severe short-term pain — after surgery, for example, or during end-of-life care. From the beginning, there has been little evidence that opioids helped patients overcome pain and still function and plenty of evidence that pain returned as patients develop a tolerance over time.
Between then and now, the lawsuit says, drug makers and distributors used all manner of techniques to push sales while downplaying and even ignoring the risks — then showing reluctance to help deal with the problem of addiction even as the crisis unfolded.
Holding them accountable for past misdeeds may not in itself solve the opioid crisis. But a similar approach through the courts targeting the tobacco industry, and the money for anti-smoking initiatives it generated, has certainly helped cut the nation’s addiction to cigarettes.
For Hillsborough, which plans to release an action plan soon for dealing with the opioid crisis, the lawsuit holds promise as a way to help pay for it some day.