Judge clears distributors of blame for opioid crisis

Federal court says it’s difficult to assign responsibility for county’s prescription deaths, addictions to single entity

A federal judge has ruled the nation’s three largest drug distributors cannot be held liable for the opioid epidemic in one of the most ravaged counties in the country — a place where 81 million prescription painkillers were shipped over eight years to a population of less than 100,000.

Judge David Faber of the U.S. District Court for the Southern District of West Virginia released the opinion on the Fourth of July holiday, almost a year after the end of a trial pursued by the city of Huntington and Cabell County, which were the focus of an Oscar-nominated documentary called Heroin(e) about the effect of the prescription painkillers.

The fatal overdose rate in Cabell County increased from 16.6 to 213.9 per 100,000 people from 2001 to 2017, according to the ruling.

In absolving the drug distribution companies — AmerisourceBergen, McKesson and Cardinal Health — Faber acknowledged the terrible cost on the county and the city but added “while there is a natural tendency to assign blame in such cases, they must be decided not based on sympathy, but on the facts and the law.”

His decision points to the difficulty of determining responsibility for a decadeslong disaster in which many entities had a role, including drug manufacturers, pharmacy chains, doctors and federal oversight agencies, as well as the drug distributors.

Drug distributors generally fulfill pharmacy orders by trucking medications from the manufacturers to hospitals, clinics and stores, and are responsible for managing their inventory. Like other companies in the drug supply chain, distributors are supposed to comply with federal limits established for controlled substances like prescription opioids and have an internal monitoring system to detect problematic orders. Lawyers for the city and county argued the distributors should have investigated orders by pharmacies that requested addictive pills in quantities wildly disproportionate to the population in these small communities.

But Faber ruled: “At best, distributors can detect upticks in dispensers’ orders that may be traceable to doctors who may be intentionally or unintentionally violating medical standards. Distributors also are not pharmacists with expertise in assessing red flags that may be present in a prescription.”

The three distributors had finalized a deal earlier this year to settle thousands of lawsuits brought by states and thousands of local governments, in which they agreed to pay $21 billion over 18 years for addiction treatment and prevention services. But Cabell County and the city of Huntington, often described as ground zero for the crisis in the United States, refused to sign on, believing they could get more money by going to trial.

Lawyers for Cabell County and Huntington, and a national opioid plaintiffs’ executive committee, released a joint statement expressing their deep disappointment.

“We felt the evidence that emerged from witness statements, company documents and extensive data sets showed these defendants were responsible for creating and overseeing the infrastructure that flooded West Virginia with opioids,” they said. “Outcome aside, our appreciation goes out to the first responders, public officials, treatment professionals, researchers and many others who gave their testimony to bring the truth to light.”