The suit filed on Sept. 28, 2017, alleges that beginning in the 1990s, the pharma companies engaged in tactics to promote the use of opioids for treatment of long-term chronic pain despite knowing that opioids were too addictive and debilitating for these purposes.
The suit states that by issuing misleading statements and marketing claims the pharma giants knowingly and willfully unleashed a prescription opioid healthcare crisis that has had far-reaching financial, social, and deadly consequences in Seattle and across the nation. The campaigns continue, and the defendants have spent – and some continue to spend – millions of dollars on promotional activities and materials that falsely deny or trivialize the risks of opioids while overstating the benefits of using them for chronic pain. These messages served to undo the popular and medically backed understanding of opioids – that opioids are addictive drugs, unsafe in most circumstances for long-term use.
"They disseminated these messages directly, through their sales representatives, and in speaker groups led by physicians Manufacturing Defendants recruited for their support of their marketing messages," the suit states. "Borrowing a page from Big Tobacco’s playbook, Manufacturing Defendants also worked through third parties they controlled by: (a) funding, assisting, encouraging, and directing doctors, known as ‘key opinion leaders’ and (b) funding, assisting, directing, and encouraging seemingly neutral and credible professional societies and patient advocacy groups."
The complaint states that opioids are now the most prescribed class of drugs; they generated $11 billion in revenue for drug companies in 2014 alone. In an open letter to the nation’s physicians in August 2016, the then-U.S. Surgeon General expressly connected this “urgent health crisis” to “heavy marketing of opioids to doctors... [m]any of [whom] were even taught – incorrectly – that opioids are not addictive when prescribed for legitimate pain.”
This epidemic resulted in a flood of prescription opioids available for illicit use or sale (the supply), and a population of patients physically and psychologically dependent on them (the demand), the suit says. When those patients can no longer afford or legitimately obtain opioids, they often turn to the street to buy prescription opioids or even heroin.
THE OPIOID EPIDEMIC IN SEATTLE
Many areas of the country saw licensed doctors operating “pill mills” dispensing opioids without regard to risks or patient needs, and the Seattle-area has been no exception to this trend.
In 2008, Frank D. Li opened the now notorious Seattle Pain Center and eventually expanded into cities across the state, including in Renton, Everett, Tacoma, Olympia, Spokane, Poulsbo and Vancouver. At least 60 SPC patients died between 2010 and 2015.
“Washington officials investigated medical records for 18 of these patients and concluded that 16 died of opioid overdoses shortly after filing an opioid prescription issued by SPC, and that the other two patients were prescribed opioids despite serious health conditions,” the complaint states.
Opioid manufacturers knew that the Seattle Pain Center was operating a “pill mill,” and that their deceptive marketing of opioids was creating addicts on which it preyed. But they did alert authorities. In fact, the complaint states, Purdue Pharma and Janssen actively promoted their drugs to Seattle Pain Center providers.
The annual number of opioid doses prescribed statewide in Washington has exceeded 112 million – enough to supply every man, woman and child living in Washington state with 16 pills each. In King County specifically, the opioid prescribing rate in 2011 was 66 percent, meaning that 66 opioid prescriptions were issued for every 100 King County residents and, despite aggressive efforts by local and state officials to combat the crisis, the prescribing rate remained above 47 percent through 2016.
In 2016, 435 people in Washington overdosed on prescription opioids – that is more than one person per day for the entire year – and heroin was linked to 287 overdose deaths.
Between 1997 and 2015, the rate of drug-involved deaths in King County spiked from 10.67 to 15.59 per 100,000 residents, a 46 percent increase. The bulk of this increase is attributable to prescription opioid and heroin overdoses.
In 2015, two out of every three drug-related deaths in King County involved prescription opioids or heroin.