SEATTLE (Legal Newsline) - An abatement plan to deal with an opioid drug overdose crisis was discussed Tuesday in the King County Superior Court trial of three major drug distributors, and the possible impact of a settlement with native tribes.
“The tribes reached a settlement," Tim Hester, attorney for McKesson, told Dr. Jeffrey Liebman, a professor of public policy at the Harvard Kennedy School and an abatement plan specialist. “You don’t know how it could reduce a settlement (in Washington State)?”
“Correct,” Liebman said.
Prescription drug distributors McKesson, Cardinal Health and AmerisourceBergen Corp. are accused of irresponsibly over-promoting and distributing opioid drugs to pharmacies and doctors' offices that led to hundreds of overdose deaths in the state. The Washington State Department of Health estimated 1,200 in 2020.
The trial is being streamed live courtesy of Courtroom View Network.
On Feb. 1, the three companies and Johnson & Johnson agreed in federal court to pay 400 native tribes across the country $590 billion to settle lawsuits launched by the tribes, which are considered their own sovereign entities.
In a Bloomberg Law report, U.S. District Judge Dan Polster said native peoples have suffered more than other ethnic groups in the opioid epidemic.
“The Native American population has suffered some of the worst consequences of the opioid epidemic of any population in the United States,” he said. “It has imposed severe financial burdens on tribal governments to cover increased spending on health care, social services, child welfare, law enforcement and other government services.”
Washington State launched its own lawsuit against McKesson, AmerisourceBergen and Cardinal Health in a trial that began in November.
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.
Over the course of the trial attorneys for the companies have maintained that it was illegal societal misuse of drugs such as heroin and fentanyl fueled in part by a Mexican drug cartel that led to the opioid epidemic, particularly during the years 2002 to 2020. They argued that the distributors were only doing their jobs filling orders for pills from the legal prescriptions of doctors, and that each of the three companies did their best to check on suspicious orders by enacting anti-diversion plans.
Washington State Attorney General Bob Ferguson is asking for $32 billion in damages to enact anti-drug programs. A state victory could result in a much higher award when surrendered profits and penalties are added in.
On Tuesday, Liebman discussed an abatement plan which according to a displayed chart would allocate $33.5 billion for treatment, $2.9 billion for harm reduction, $989 million for prevention and $413.5 million for system coordination.
The system could treat possibly around 30,000 patients in Washington State per month. The average cost could run approximately $670 per person per month.
“Were you aware that 90% (people with substance abuse) are covered by Medicaid?” Hester asked.
In a prior deposition Liebman had said yes to a similar question, but answered “I don’t know,” to Hester.
Liebman agreed that a similar abatement plan was enacted in Rhode Island.
“In Rhode Island the state would actually pay for about 33%,” Hester said.
“Assuming historical trends continued,” Liebman agreed.
“Washington would be similar, right?”
“Different states have different Medicaid rates,” Liebman said.
“You haven’t done a determination on how much Washington Medicaid and private insurance would pay? It (settlement) could be $20 billion less.”
“I’d have to do the calculations,” Liebman said.
‘Do you have any reason to think the estimates (abatement plan) are inaccurate?”
“No.”
Everett Maroon, executive director of Walla Walla-based Blue Mountain Heart to Heart, a nonprofit public health advocacy and treatment organization with an emphasis on HIV prevention, testified next. He told Tad Robinson, attorney for the state, that the problem of opioid addiction was acute particularly in rural areas of the state.
“People (seeking help) often have to drive 150 miles to Yakima or Spokane and they have no way to get through initial (drug) withdrawal,” he said.
“Is it (epidemic) getting worse?”
“In my opinion, yes,” Maroon said.
Maroon told the court the agency’s syringe exchange program which attempts to cut disease spread including HIV a few years ago saw 150,000 syringes exchanged in a year. In 2020 the figure was 577,000.
Josh Podoll, attorney for Cardinal Health, asked Maroon if he knew what drug had been in each syringe exchanged.
“I don’t test it but I take their (drug user) word about what drug they’ve used,” Maroon said.
“You can’t say if the syringe was used for heroin?”
“I take them at their word,” Maroon repeated.
“You understand that (drug orders) wholesale don’t include illicit fentanyl?” Podoll asked.
Maroon agreed.
“Fentanyl is a major driver of illegal drug users.”
“Yes.”
“Are you aware it appears in pill form?”
“Yes.”
“It’s referred to as ‘blues.’”
“Yes.”
Podoll said the drug is also referred to as “Mexies” for the drug cartel in Mexico.
“You can grind them (pills) up and smoke them,” he added.