The anger is clear and understandable as the city of Everett continues to fight an epidemic of heroin and opioid abuse and addiction that has brought with it crime, homelessness, poverty and death.
Mayor Ray Stephanson wants the city to hold one of the players in that epidemic responsible.
“We are going to go at them, and we are going to go at them hard,” Stephanson told The Herald in a report Wednesday by reporters Diana Hefley and Scott North that said the city was considering a lawsuit against the makers of OxyContin, a prescription painkiller.
Stephanson was expected to discuss the issue Wednesday night with the city council, seeking its approval to go ahead with a lawsuit against Purdue Pharma, which introduced OxyContin in 1996, a time-release formulation of oxycodone, a powerful opioid painkiller in use for decades.
Having studied the issue for months, the mayor and city staff say the case would make two allegations:
That Purdue was negligent in how it marketed OxyContin as a painkiller with a lower risk for abuse and addiction; and
That it ignored evidence that large quantities of the drug were being diverted to “pill mills” and the black market.
Looking at media reports, including in The Herald and The Los Angeles Times, Everett can make that case.
A Times report in July recounted that Everett authorities learned large amounts of the drug were coming from a Los Angeles clinic, brought north and trafficked in the Everett area. The Times story reports that Purdue Pharma was aware of the quantities of the pain killer processed by the California clinic but had not shared that information with law enforcement until after the drug ring had been brought down and more than 1 million pills had entered the black market.
A second investigation, reported by The Herald, focused on an Everett pain clinic operated by an osteopath who during a 10-month period in 2009 prescribed nearly 88,000 doses of OxyContin’s 80 milligram pill, its highest dose. That’s compared to Providence Regional Medical Center Everett, which ordered 13,400 tablets during the same period, court papers said.
That’s a difference in demand that should have been noticed by Purdue officials and brought to the attention of authorities.
This would not be Purdue’s first visit to court. In 2007, the company and three executives pleaded guilty to criminal charges that they misled regulators, doctors and patients about OxyContin’s risks of addiction and potential for abuse, The New York Times reported. Purdue agreed to pay $600 million in fines and other payments, and the three executives agreed to fines totaling $34.5 million.
In response to the suit and other pressure, Purdue reformulated OxyContin in 2010, making it more difficult to abuse by crushing it and smoking it.
But a May report by the Los Angeles Times shows that even after being reformulated, the drug still may be open to abuse or leave pain patients more likely to move to heroin, which is cheaper and can be easier to obtain than OxyContin.
Purdue tells doctors to prescribe OxyContin only twice a day, once every 12 hours. But many patients say that the drug’s pain relief often lasts as little as six to eight hours. Rather than allowing three or four doses a day, Purdue has stressed to doctors that they should increase the size of the dose, rather than the frequency.
The result, the Times said, is that more than half of long-term OxyContin users are on doses that public health officials consider dangerously high, because the higher doses result in higher highs and lower lows for patients. Patients for who the drug is not effective for the full 12 hours can suffer a return of pain and the beginning stages of withdrawal.
“That becomes a very powerful motivator for people to take more drugs.” Theodor Cicero told the Times. Cicero is a neuropharmacologist at the Washington University School of Medicine in St. Louis and a leading researcher on how opioids affect the brain.
Since OxyContin’s introduction 20 years ago, the painkiller has generated $31 billion in revenue for Purdue.
In going after Purdue Pharma, Everett city officials wouldn’t be just chasing after a deep pocket; they’d be attempting to recoup some of what we’ve lost to a drug that wasn’t well monitored and remains too easily abused.