HUNTINGTON — A request to dismiss the case against opioid firms accused of adding fuel to the fire that is the opioid crisis by shipping hundreds of opioid dosages to Cabell County and Huntington will loom over the trial as the defense presents its witnesses.
The evidence shows AmerisourceBergen, Cardinal Health and McKesson shipped more than 127 million dosage units of opioids into the county over an eight-year period. Attorneys say a systematic failure of the companies’ suspicious ordering monitoring system, combined with company executives seeking to make as much profit as possible, led to an unnecessary amount of pills being shipped.
The distribution companies hold the Drug Enforcement Administration, doctors and West Virginia’s history of poor health as the reason for the shipments.
The trial is expected to wrap up near the end of July.
The governments’ attorneys, led by Cabell County attorney Paul T. Farrell Jr., first turned the courtroom into a schoolhouse, educating the judge — who will decide guilt — on the science and history behind opioid addiction. Local officials testified to the effects they see as first responders. The plaintiffs called to the stand executives and sales people from each of the three companies.
Emails from some witnesses showed them mocking Appalachia and its opioid abuse. The testimony showed that when problematic pharmacies were closed within the city, more came in to take their place.
A DEA official and marketing specialist said the defendants had been at fault in the raging crisis through sophisticated marketing and public relations strategies, while ignoring regulatory duties under the Controlled Substances Act.
Witnesses testified that while Huntington has a strong foundation for its road to recovery, it is just a drop in the bucket compared to what is needed.
Finally, three epidemiologists took the stand, testifying about the gateway between prescription opiates and heroin and the $3 billion harm that prescription opioids have put on the area.
Their case, which took 32 days of testimony to make, came to a head last week with the plaintiffs unveiling the $2.6 billion abatement plan they said would cut opioid use disorder in half in 15 years.
Huntington Mayor Steve Williams wrapped up the plaintiffs’ case Wednesday, testifying about how Huntington went from attempting to arrest its way out of the crisis to becoming the opioid capital of the country.
The defense’s first witness, Christopher Gilligan, chief of the Division of Pain Medicine at Brigham and Women’s Hospital, testified Friday to the gravity doctors have to use when determining whether opioids should be prescribed. He said they had to weigh the risks and benefits of opioid prescribing, while trying to satisfy the ever-changing policies of their regulators and medical boards who set prescribing standards.
Gilligan’s testimony also strengthened the plaintiffs’ case of there being a gateway between prescription opioid abuse and the move to heroin, which the judge had previously said was weak.
The case came to a head Thursday when the defense asked that the case be tossed out, a standard practice during trials, because they said the plaintiffs did not prove their case.
The defense did not argue that the actions of which they are accused did not happen. Instead, they claimed state and federal law hold conduct must be proximate, not remote, for them to be civilly liable for them. They argued that the proximate conduct was that of doctors over-prescribing, illicit drug dealers and others.
U.S. District Court Judge David A. Faber, the cases’ decider, questioned if the public nuisance law was broad enough to address the plaintiffs’ cause of action, telling the plaintiffs they had cast a far-reaching net.
The defense said the $2.6 billion plan called for them to fix harms caused by people who have not yet been diagnosed with opioid use disorder and people who have not taken prescription pills.
Farrell asked the judge to imagine all people affected by the opioid use disorder placed in a pond polluted by multiple sources: community members, past and present prescription and illicit opioid users, governments, etc.
A company could be forced to clean the pond, but it would also screen the pollutants dumped by others, but that did not mean the treatment facility was not needed in the first place, Farrell said.
The defense said the city and county did not pay for, nor run, recovery programs, thus could not be given money to do so. But the plaintiffs said state statute said it is their duty to abate the problem.
Faber decided to let the case move forward and will issue a decision at a later time.
