State evidence and Ottoway
NORMAN, Okla. (Legal Newsline) - Cleveland County District Judge Thad Balkman overruled several objections made by Johnson & Johnson/Janssen Pharmaceuticals (J&J) as the second day of trial unfolded in the state's pursuit of abatement in what it calls a man-made opioid crisis.
Though the trial attracted widespread national media attention at Tuesday's opening, only a small crowd trickled into the courtroom to hear the state call its first witnesses.
First up was Craig Box, father of 22-year-old son, Austin, who overdosed on a cocktail of prescription painkillers and died in 2011.
“Austin was the youngest of three children…he was a wonderful child. He was just a really kind-hearted, sweet boy. He was extremely athletic, excelled in all sports; football, basketball and baseball,” Box said with tears in his eyes. “It really didn’t hit us until the funeral.”
Box, an business attorney from Enid, Okla., recounted multiple injuries his son had received over the years from a fracture in his lower back in high school to a ruptured disk at the University of Oklahoma, some of which his son received medications containing opioids.
“We never suspected anything,” Box said, adding that his wife found a prescription bottle at home with several pills left after their son’s ruptured disk in 2010. “You don’t have to look far to find them, you don’t have to get a prescription…they are everywhere.”
J&J asked only one question during cross-examination, whether or not Box knew if his son had taken any of their company’s drugs specifically.
Box answered that he did not know if Austin used Johnson&Johnson/Janssen medications.
The state also introduced video testimony of Russell Portenoy, director of MJHS Institute for Innovation in Palliative Care.
“The pharmaceutical industry should accept partial responsibility,” Portenoy said, adding that the messaging in much of the marketing work done, in part, drove doctors to prescribe more opioid drugs, leading to ultimately deaths.
“Their conduct in marketing without context contributes to the public health problem," Portenoy stated in the deposition taken in January.
He said companies would use statements from his work without mentioning the risks also stated, which were helping to market the interest of the companies.
“As an academic who was trying to educate professionals and include benefit and risk, that was the goal - to provide education at that time,” Portenoy said. “There was no understanding on my part that it would be used as a marketing strategy.”
He said that from the very first paper he published in 1986, the pharmaceutical industry would take out pertinent information, including the first guideline written saying opioids should only be used after all others have been considered.
Portenoy said removing the risks from marketing opioid gave companies such as J&J an advantage in the the market.
“I think the purpose of doing that was to improve the sale of their drugs,” he said. “The drug companies were slow to incorporate more about risks; they tended to only market the positive and not disclose the negatives. Risk was negated in marketing materials and could have swayed the broad perception of opioids.”
Having interacted with the industry for several years, Portenoy claims chronic pain was being viewed as a public health problem.
“I always framed that these drugs could be addictive and abused, and should be monitored,” Portenoy said.
He also admitted there are still patients who could benefit from schedule II opioid prescriptions such as his mother, who uses long-term opioid therapy for arthritis. He also mentioned one of his patients who has been on a long-term prescription for about 20 years.
Brad Beckworth, a lawyer for the state, declined to comment on the trial, noting the state will not be agreeing to exclusive interviews until the case comes to a close. The trial against the pharmaceutical companies for creating a public nuisance, or the opioid crisis, is set to last about two months.