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Seattle, state sue 'Big Pharma' over pain pill marketing

Seattle and the state of Washington are suing opioid manufacturers

Stephen Cohen, Seattle pi, Sep 28, 2017

Attorneys for the city of Seattle and Washington state are going after pharmaceutical companies they say fueled the country's opioid epidemic by hiding the risk of addiction posed by popular pain pills.

In a Thursday press conference at Harborview Medical Center in Seattle, City Attorney Pete Holmes and state Attorney General Bob Ferguson announced two lawsuits against major drug companies. Those named as defendants in the Seattle suit including Purdue Pharma, Teva Pharmaceuticals, Johnson & Johnson and Janssen Pharmaceuticals, among several others. The state named only Purdue, the maker of OxyContin, as a defendant.

"Purdue has made billions of dollars by fueling Washington's opioid epidemic by knowingly deceiving doctors and the public about the risks of long-term opioid use," Ferguson said.

In addition to civil penalties, the state's suit targets any profits Purdue made in Washington state. The state suit was filed in addition to action it's already take alongside other states, and Ferguson said the suit against Purdue did not preclude his office from suing other opioid producers.

Both suits allege companies misled doctors and other healthcare providers by not disclosing the "addictive and debilitating" nature of opioids -- powerful narcotic pain relievers that include oxycodone and hydrocodone.

The suits come as the state and nation try to address a spike in opioid addiction. According to data collected by the University of Washington's Alcohol & Drug Abuse Institute, opioid use has skyrocketed over the past decade, with around 700 people in the state dying from opioids each year. About 10,000 have died since 2000.

Between 2009 and 2014, the state saw a 60 percent increase in opioid-related hospitalizations, Ferguson said, the fourth-highest increase in the nation, adding that in 2015 the number of overdose deaths in the state exceed the number of deaths from car accidents or firearms.

Holmes connected prescription opioid abuse to heroin use and said the city spends roughly $15 million annually on Seattle's homelessness issue, a primary cause of which is drug use.

"Unlike earthquakes and hurricanes, this disaster is a human-made crisis," Holmes said. "The lawsuit that I filed today on behalf of the city of Seattle is to hold accountable first and foremost those who have caused harm to the city."

In its lawsuit, the city argues doctors generally avoided prescribing opioids for chronic pain until drug companies began pushing them do to so in the 1990s. The city said drug companies then spent millions on "promotional activities and materials that falsely deny or trivialize the risks of opioids while overstating the benefits of using them for chronic pain."

Ferguson referenced promotional material that claimed that less than 1 percent of Purdue's patients developed opioid addictions, a number he believes was pulled from a 1980 letter to the editor from The New England Journal of Medicine.

"Purdue Pharma has knowingly conducted an uncontrolled experiment on the people of Washington state and the American public without any reliable clinical evidence that opioids are safe -- or even effective -- for long-term, chronic pain," Ferguson said.

Companies are alleged to have purposely disseminated inaccurate information through sales reps and physicians recruited the the drug companies for the purpose of selling their products to their colleagues. In addition to downplaying the risk of addiction and claiming that opioid abuse was easily managed, the city argues that companies promoted the concept of "pseudoaddiction," which advocates for the treatment of addiction with more opioids.

"When signs of addiction appeared in their patients, Purdue persuaded doctors that what appeared to be addiction was actually under-treatment of their pain and to respond to that by increasing opioid dosages," Ferguson said.

In a statement released to SeattlePI, Purdue Pharma said it was "deeply troubled" by the opioid crisis and "dedicated to being part of the solution."

"We vigorously deny these allegations and look forward to the opportunity to present our defense," wrote Purdue's John Puskar.

Purdue pointed out that FDA-approved labeling for OxyContin "embodies this concept" of pseudoaddiction.

Earlier this month, Purdue asked that a suit similar to those filed Thursday be thrown out of court since OxyContin has been approved by the Federal Drug Administration for the treatment of chronic pain. The FDA's approval trumps any state claims, they argue, and if current FDA studies disprove the company's claims about the benefits of opioids, the state would still need to prove Purdue made the claims knowing they were false at the time.

"A stay in favor of FDA's primary jurisdiction is appropriate," Purdue wrote in a memo requesting a temporary suspension in the case brought by the state of Ohio in May. "It will allow FDA to complete its scientific evaluation, apply its medial and regulatory expertise, and address important and complex public health questions concerning proper use of these medications."

In an email to SeattlePI, Denise Bradley of Teva Pharmaceuticals said that the company recognized the "critical public health issues" caused by illegal drug use and was "committed to the appropriate use of opioid medicines."

"Teva offers extensive resources for prescribers, patients and pharmacists regarding the responsible pain management and prevention of prescription drug abuse," Bradley wrote. "Teva also collaborates closely with other stakeholders, including providers and prescribers, regulators, public health officials and patient advocates, to understand how to prevent prescription drug abuse without sacrificing patients' needed access to pain medicine."

Ferguson and Holmes were joined at the press conference by Rose Dennis, whose son became addicted to opioids while undergoing treatment for leukemia as a 12-year old. The boy spent nine months hooked up to an opioid drip to deal with the pain caused by chemotherapy, Rose Dennis said.

"I remember visiting him one day at the hospital, and he shared, 'Mom, this is my happy time,' and asked me to leave the room," she said. "I left the room in tears knowing we had a serious problem."

Their son, now 31, has been battling opioid addiction for 18 years, she said.

The suit is the latest high-profile episode for Ferguson, who became a national celebrity for successfully challenging the Trump administration's travel ban in court. Ferguson is rumored to be considering a run for governor in 2020.

"Blinded by pursuit of profits -- billions and billions of dollars -- they ignored what was going on in our communities all across this country for their bottom line. That's not right. It's our job to hold them accountable for that.

"I don't know how executives at Purdue Pharma sleep at night," he said.

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