Biggest civil trial in U.S. history to start in Ohio

PARMA, Ohio — At Knuckleheads Bar & Grill, the subject on a sweltering Saturday afternoon was the drug crisis. More specifically, the recent disclosure that the CVS across the street received more pain pills — 6.4 million — over a seven-year period than any other drugstore in Cuyahoga County.

“Location, location, location,” said Mike Gorman, 37, who was drinking and hanging out with friends. “It’s right near the highway, which makes it easy to access” from Cleveland.

The CVS in this white workingclass suburb of Cleveland is a three-hour drive and, culturally, even further from the southern Ohio section of Appalachia that has become widely associated with the opioid epidemic.

But last week’s revelation that drug companies saturated the United States with 76 billion pain pills over seven years shows no corner of the country escaped the drug crisis. Two other drugstores in this city of 80,000 placed second and fifth on the Drug Enforcement Administration’s list of Cuyahoga County locations. Wholesalers shipped opioids at 5.4 million and 3.7 million doses, respectively, to those. The list was disclosed by the Washington Post and HD Media last week.

A ‘public nuisance’

Cuyahoga County and nearby Summit County soon will be at the center of the most important legal test of how much responsibility drug companies bear for the opioid epidemic. Barring a settlement, the two counties are scheduled to go to trial in October as the first case among the consolidated lawsuits brought by about 2,000 cities, counties, Native American tribes and other plaintiffs.

U.S. District Judge Dan Polster, who is presiding over the consolidated case in Cleveland, selected the counties to represent the legal arguments that other plaintiffs have made. The two counties are asking for billions of dollars from companies to help stem the crisis.

In a statement to the Post last week, CVS made a distinction between the opioids it dispensed from its in-house distribution arm and those it dispensed from other drug distributors.

CVS distributed hydrocodone while it was a Schedule III drug. When hydrocodone was moved to Schedule II in 2014, CVS stopped distributing it because Schedule II drugs require enhanced security measures. The company did not distribute oxycodone to its stores because it has always been a Schedule II drug.

But CVS has always dispensed oxycodone and hydrocodone shipped by other distributors and continues to do so.

In a court filing released Friday, lawyers for the two counties accuse some of the biggest names in the drug industry of creating a “public nuisance” that endangered the health of residents by failing to control the drug flow, even when they knew, or should have known, that some painkillers were being diverted to illegal use.

Pharma giants respond

The defendants in the case include giant drug distribution companies such as McKesson, Cardinal Health, AmerisourceBergen, Walgreens and Walmart, and manufacturers such as Purdue Pharma and Mallinckrodt.

The companies have generally blamed the epidemic on overprescribing by doctors, overdispensing by pharmacies and drug abuse by customers. The companies say they were working to supply patients in desperate need of pain relief with legal, highly regulated drugs.

In its statement last week, CVS said “the plaintiffs’ allegations about CVS in this matter have no merit, and we are aggressively defending against them. The fact is that we are committed to the highest standards of ethics and business practices, including complying with all federal and state laws governing the dispensing of controlled substance prescriptions.”

The public nuisance argument is the same one made by the state of Oklahoma in a seven-week trial against Johnson & Johnson that concluded last week. The state asked a judge to make the company pay as much as $17.5 billion over 30 years to clean up the drug crisis. Cleveland County District Judge Thad Balkman said he would rule around the end of August.

Another 48 states have sued drug companies and are lined up behind Oklahoma in a legal track that runs parallel to the enormous federal “multi-district litigation” in Ohio.