San Francisco wants to hold the prescription drug industry responsible for the opioid crisis. Here are 3 reasons why the current lawsuit is unique

With billions of dollars at stake, San Francisco on Monday opened a lawsuit in federal court against Walgreens Pharmacy and three companies that manufacture or distribute opioids.

The companies have routinely “overstated the benefits and trivialized the risks of long-term opioid use” for their customers, City Attorney David Chiu’s office said in a filing with U.S. District Judge Charles Breyer of San Francisco, presiding over the non-jury trial.

Opioids include legally prescribed painkillers such as OxyContin and Vicodin, legal and illegal forms of the powerful fentanyl, and heroin. They can be very addictive and sometimes deadly. According to the American Society of Addiction Medicine, cited in City’s lawsuit, 80% of American heroin users over the past decade started with opioid prescriptions. In San Francisco, health officials say 712 people died of opioid overdoses in 2020, and a quarter of all emergency room visits at the city’s General Hospital involve opioids.

Although legal efforts to hold companies and individuals accountable for fueling the opioid epidemic have been ongoing for years, the San Francisco case is unique in several ways.

This is the first lawsuit in the country against members of the three links in the supply chain: manufacturers, distributors and pharmacies.

Other lawsuits have primarily targeted drugmakers such as Purdue Pharma, which was an early defendant in the San Francisco lawsuit but has now settled claims nationwide while filing for bankruptcy.

The lawsuit, filed in 2018, accuses the companies of using deceptive advertising to boost sales, pushing more opioids onto the market than was medically necessary and failing to design and implement effective controls. The central legal argument is that the companies have created a “public nuisance,” defined by state law as a private action that harms public health.

In an opening statement Monday, Richard Heimann, a private attorney with the city’s legal team, said that when an investigator questioned pharmacists at Walgreens about a dramatic increase in opioid prescriptions by doctors at the end of the 2000s and early 2010s, the typical response was that asking questions “was not their job. … I’m not a doctor, I’m a pharmacist.

Heimann played part of a recording of a Walgreens pharmacist in San Francisco who told city attorneys she was under “pressure to fill, fill, fill… That was what mattered most to the company”.

“We are not looking to ban opioids. We recognize their value,” Aeilish Baig, another private attorney representing the city, told Breyer. “But we demand the truth.”

Other defendants in the lawsuit are drugmakers Teva Pharmaceuticals and Allergan, and Anda, a Teva-owned distributor. All have denied responsibility for opioid addictions and deaths.

Although opioids have “a high potential for abuse,” Allergan said in a court filing, the labels of its prescription drugs have been approved by the U.S. Food and Drug Administration and should therefore be considered legal under state and federal laws.

Other cities and counties were barred from advancing similar lawsuits.

Oakland and Los Angeles, Orange and Santa Clara counties filed a similar lawsuit against multiple drugmakers and distributors in a 2014 lawsuit in state court. But Orange County Superior Court Judge James Wilson ruled in favor of the companies last November after presiding over a trial without a jury, citing FDA findings that the drugs’ potential for abuse was outweighed. by their benefits as analgesics, and that they could be safely prescribed by experienced physicians.

But Breyer declined to dismiss San Francisco’s lawsuit and said the city’s allegations, if proven, could show violations of the law.

Many opioid cases have settled; he proceeds to a trial.

San Francisco has settled its claims against several companies. The city expects to receive between $50 million and $61 million in deals struck last fall with AmerisourceBergen Corp., Cardinal Health Inc., McKesson Corp. and Johnson & Johnson, said Jen Kwart, a spokeswoman for Chiu. Last week, Chiu’s office announced a $10 million settlement with Endo Pharmaceuticals, maker of the drug Percocet, with $5 million to be paid upfront and the rest over the next 10 years.

In March, Purdue Pharma and its owners, the Sackler family, all defendants in the San Francisco lawsuit, reached a $6 billion settlement with a number of states, including California, which will receive $500 million in company bankruptcy proceedings.

Several thousand opioid lawsuits brought by state and local governments nationwide have been transferred to a federal judge in Ohio, who has approved a handful, including one in San Francisco, as ‘indicator’ cases. to be judged.

The trial is expected to last six to eight weeks.

Bob Egelko is a writer for the San Francisco Chronicle. Email: [email protected]: @BobEgelko

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