WASHINGTON (Legal Newsline) - A specialist witness called by the State of Washington on Thursday said children’s health in the state is being damaged and child welfare services overwhelmed by an epidemic of opioid abuse.
Defense attorneys representing three of the country’s biggest distributors of opioids continued to hammer at the theme that it was illegal use of drugs that caused the epidemic and not legally proscribed pills.
“Has there been an epidemic effecting children and families in Washington?” Annie Kouba, attorney for the state asked.
“Yes,” Dr. Nancy K. Young answered. “It has had a profound effect. The increasing number of infants put in out-of-home care is extremely concerning. There is a tremendous burden on the child welfare system.”
Young is executive director for the research and policy institute Children and Family Futures based in Lake Forest, Calif.
Children are removed from homes of drug abuser parents and institutionalized in the child welfare system for their own safety, Young explained. A growing number suffered physical damage before birth while in the womb of an opioid-using mother.
Prescription drug distributors McKesson, Cardinal Health and AmerisourceBergen Corp. are accused of irresponsibly over-promoting and distributing opioid drugs to pharmacies and doctor’s offices that led to multiple overdose deaths in the state. The Washington State Department of Health estimated 1,200 in 2020.
The trial in the King County Superior Court is being streamed live courtesy of Courtroom View Network.
The lawsuit launched by Washington State Attorney General Bob Ferguson is asking for $32 billion in damages to enact anti-drug programs, but a state victory could result in a much higher award when surrendered profits and penalties are added in.
Distributors take pills from the manufacturers and supply them to hospitals, doctor’s offices and pharmacies. The most commonly shipped opioid drugs include OxyContin, Hydrocodone, methadone and fentanyl.
Young told Kouba that the Centers for Disease Control (CDC) had found in a survey that 6.6% of women had used prescription opioids during pregnancy.
“That is striking,” Young said. “It’s the largest (increase) we’ve seen.”
Young explained that a fetus exposed to opioid use by the mother before birth exhibited withdrawal symptoms after birth. The symptoms included difficulty in (breast) feeding, gastrointestinal problems, tremors, seizures, rigidity of the body, irritability and crying, and problems sleeping. In addition, young children impacted by the drugs experienced learning delays in school, lower IQ testing, developmental and health problems, more neuro hospitalizations and disabilities.
In high school they more often had behavorial and academic difficulties.
“This has had a dramatic impact on the child welfare system,” Young said. “In Washington (State), 1,450 children were put in the out-of-home care system to protect them and to find (alternate) homes.”
Young said out-of-home adolescents who come out of the institutional care system often do not see good outcomes.
“The (child care) system is not a good parent,” she said.
Young added that such adolescents are often not prepared for adulthood, and have higher rates of suicides and behavioral problems.
Young indicated the health care system needs to be improved with strengthened observation, intervention and counseling. Early identification, shared mission, recovery support systems, staff development and training, as well as family-centered treatment are needed, she said.
The goal she noted is recovery and family reunification.
“Can it (epidemic) be abated?” Kouba asked.
“We have the ability,” Young answered. “We need to shore up the (health care) workers on the front line."
Under cross examination, Kim Watterson, attorney for Cardinal Health, asked Young if her opinions were based on the conduct of the three defendant companies.
Young said they were not.
“You were talking about prescription opioids?” Watterson asked.
“That would be correct,” Young said.
“They are being used and misused.”
Young agreed.
“Including heroin and fentanyl.”
“Yes, those are in a class of opioids,” Young said.
Watterson said of the CDC figures presented by the state, 6.6% of women reported using opioids at pregnancy, and most of them had received the opioids from a health care provider (doctor).
“Correct,” Young said.
A survey stated that a majority of the women (63%) said they had received the prescription pills during pregnancy to reduce pain from a surgery or an injury, while 22% said they took opioids before pregnancy for the same reasons. Approximately 11% couldn’t recall when they took such pills.
“NAS (child drug withdrawal) can result from a substance other than opioids,” Watterson said.
“Correct,” Young said.
“It could be from mis-use, or use of an illegal drug. That could produce an NAS diagnoses. The chart exhibited (by plaintiff lawyers) was not limited to prescription opioids.”
Young agreed.
“It could be heroin or other opioid synthetics (fentanyl),” Watterson said.
“That’s correct.”
Watterson said the plaintiff charts shown did not place the blame specifically on prescription opioid drugs for the problems. For example, she added, the reason a child had been removed from their home and placed in child care could be for any number of reasons including parental neglect.