CVS, Walgreens, Walmart Responsible For Roles in Opiod Crisis, Jury Finds

Ruthanne

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CLEVELAND — Three retail pharmacy chains recklessly distributed massive amounts of pain pills in two Ohio counties, a federal jury said Tuesday in a verdict that could set the tone for U.S. city and county governments that want to hold pharmacies accountable for their roles in the opioid crisis.

The counties blamed pharmacies operated by CVS, Walgreens and Walmart for not stopping the flood of pills that caused hundreds of overdose deaths and cost each of the two counties about $1 billion, their attorney said.


This was the first time pharmacy companies had completed a trial to defend themselves in a drug crisis that has killed a half-million Americans over the past two decades. How much the pharmacies must pay in damages will be decided in the spring by federal judge.

Lake and Trumbull counties were able to convince the jury that the pharmacies played an outsized role in creating a public nuisance in the way they dispensed pain medication into their communities.

Attorneys for the three pharmacy chains maintained they had policies to stem the flow of pills when their pharmacists had any concerns and would notify authorities about suspicious orders from doctors.

They also said it was the doctors who controlled how many pills were being prescribed for legitimate medical needs.

Two other chains — Rite Aid and Giant Eagle — already have settled lawsuits with the two Ohio counties.

Attorney Mark Lanier, who represented the counties in the lawsuit, said during the trial that the pharmacies were attempting to blame everyone but themselves.

The opioid crisis has overwhelmed courts, social services agencies and law enforcement in Ohio’s blue-collar corner east of Cleveland, leaving behind heartbroken families and babies born to addicted mothers, Lanier told jurors.

Roughly 80 million prescription painkillers were dispensed in Trumbull County alone between 2012 and 2016 — equivalent to 400 for every resident.

In Lake County, some 61 million pills were distributed during that period.

The rise in physicians prescribing pain medications such as oxycodone and hydrocodone came at a time when medical groups began recognizing that patients have the right to be treated for pain, Kaspar Stoffelmayr, an attorney for Walgreens, said at the opening of the trial.

The problem, he said, was that “pharmaceutical manufacturers tricked doctors into writing way too many pills.”

The counties said pharmacies should be the last line of defense to prevent the pills from getting into the wrong hands.

They didn’t hire enough pharmacists and technicians or train them to stop that from happening and failed to implement systems that could flag suspicious orders, Lanier said.

Click on Link at top of page for full article.

I really haven't given this a whole lot of thought at who is responsible or not but part of me does not think the drug stores are responsible. I have to give this a lot more thought. I read the full article and it's something to consider.
 

I'm certainly not an expert on this topic, but I fail to see how pharmacies are at fault when it was the physicians who were writing the prescriptions and the pharmacies were simply filling the prescriptions. I know that if I need a prescription refilled the pharmacy has to contact my doctor for approval. I'm willing to be educated.
 
I'm certainly not an expert on this topic, but I fail to see how pharmacies are at fault when it was the physicians who were writing the prescriptions and the pharmacies were simply filling the prescriptions. I know that if I need a prescription refilled the pharmacy has to contact my doctor for approval. I'm willing to be educated.
That’s how I perceive it too.
 
The complaint in part claims the pharmacies were reckless in their distribution and were a public nuisance. Just because, for example, a doctor writes 100 scripts for someone, that does not mean they are immune from dispensing them if harm is caused. Oh you can bet the U.S. 6th Circuit Court of Appeals will be busy now.


https://codes.ohio.gov/ohio-revised-code/section-4729.35
Yes I heard they will be appealing.
 
Another case of finding a scapegoat for our own bad behavior.

I agree that the pharmacists and the health insurance companies should have a system in place to report suspected abuse.

IMO lawsuits like this will increase prescription costs for all of us and make it more difficult for people that need narcotic strength painkillers, but it will do little to prevent drug abuse.
 
I would place most of the blame on the doctors who were overprescribing these drugs. A pharmacy is just there to supply whatever the doctor ordered.

Up until a couple of years ago, it seemed that every time I went to a doctor, they asked if I wanted a prescription for pain pills...usually OxyContin. I did get a small bottle of those pills once, and took a couple....made me half loopy. I found Aleve or Tylenol to be just as effective without the cocaine "side effects". Eventually, I took the rest of that junk to one of the local police drug disposal events.

The biggest problem, IMO, is the kickbacks the drug companies give to the doctors for writing prescriptions. That should NOT be allowed, IMO.
Here's a site that tracks such activity.....

https://www.propublica.org/series/dollars-for-docs
 
I would place most of the blame on the doctors who were overprescribing these drugs. A pharmacy is just there to supply whatever the doctor ordered.

Up until a couple of years ago, it seemed that every time I went to a doctor, they asked if I wanted a prescription for pain pills...usually OxyContin. I did get a small bottle of those pills once, and took a couple....made me half loopy. I found Aleve or Tylenol to be just as effective without the cocaine "side effects". Eventually, I took the rest of that junk to one of the local police drug disposal events.

The biggest problem, IMO, is the kickbacks the drug companies give to the doctors for writing prescriptions. That should NOT be allowed, IMO.
Here's a site that tracks such activity.....

https://www.propublica.org/series/dollars-for-docs

Very true. In the late 90s when I worked as Dept Head for Food and Nutrition Services at an acute care hospital, surveyors for the US hospital national acceditation body pulled charts and cited hospitals for failing to constantly monitor pain and treat with RX meds--mostly opiates. Google 'pain, the fifth vital sign' and you'll find a lot of hits including academic articles supporting the pain meds movement.

From the article:

The rise in physicians prescribing pain medications such as oxycodone and hydrocodone came at a time when medical groups began recognizing that patients have the right to be treated for pain, Kaspar Stoffelmayr, an attorney for Walgreens, said at the opening of the trial.

The problem, he said, was that “pharmaceutical manufacturers tricked doctors into writing way too many pills.”
 
Like the recent $137 million award from the San Francisco federal court jury for racial discrimination, civil rights lawyers try such cases where they are more likely to fill juries with those with attitudes that are likely to convict despite logic. The suing elevator operator was actually not an employee but rather a contractor and the only evidence given was slurs by other contractors not Tesla employees nor witnessed by any. In fact those other contractors were the same race as the person in the suit. High tech companies in the SFBA tend to support low end jobs through contracting companies, jobs like building maintenance, logistics, janitors, etc while hiring internally for positions only college graduate fulfill. Most such corporate employees rarely have to interface with such contractors and tend to ignore them as they go around quietly performing whatever work.

https://news.yahoo.com/tesla-probably-wont-pay-full-093000825.html?fr=sycsrp_catchall
 
Like the recent $137 million award from the San Francisco federal court jury for racial discrimination, civil rights lawyers try such cases where they are more likely to fill juries with those with attitudes that are likely to convict despite logic. The suing elevator operator was actually not an employee but rather a contractor and the only evidence given was slurs by other contractors not Tesla employees nor witnessed by any. In fact those other contractors were the same race as the person in the suit. High tech companies in the SFBA tend to support low end jobs through contracting companies, jobs like building maintenance, logistics, janitors, etc while hiring internally for positions only college graduate fulfill. Most such corporate employees rarely have to interface with such contractors and tend to ignore them as they go around quietly performing whatever work.

https://news.yahoo.com/tesla-probably-wont-pay-full-093000825.html?fr=sycsrp_catchall
Are you sure you're posting in the right thread? What you posted seems like nothing to do with the case.
 
I would place most of the blame on the doctors who were overprescribing these drugs. A pharmacy is just there to supply whatever the doctor ordered.

Up until a couple of years ago, it seemed that every time I went to a doctor, they asked if I wanted a prescription for pain pills...usually OxyContin. I did get a small bottle of those pills once, and took a couple....made me half loopy. I found Aleve or Tylenol to be just as effective without the cocaine "side effects". Eventually, I took the rest of that junk to one of the local police drug disposal events.

The biggest problem, IMO, is the kickbacks the drug companies give to the doctors for writing prescriptions. That should NOT be allowed, IMO.
Here's a site that tracks such activity.....

https://www.propublica.org/series/dollars-for-docs
I tend to agree with you Don. I also think the manufacturers play a role in this too and in a big way.

Some don't realize just how addicting these opioids are-after taking a prescription of them often a person becomes addicted and if not by the first prescription then the second or third. Opioids don't care who you are--they will addict you pretty fast.

A doctor has a choice to keep prescribing them for a person or limit the prescription to just one script during a pain problem. I can see prescribing them more often for someone with Cancer and/or dying, though.

Therefore I don't blame the people who become addicted, it's the drug's fault, the doctor's fault and the manufacturers fault before them. The drug companies are well aware of how addicting these drugs are yet keep making tons of them and then going around to doctors offices pushing them. I have seen drug company reps at doctors offices many times.
 
The issue that I have with people that become addicted and the doctors that continue to prescribe for them is that they don’t step forward to seek treatment like they would with any medical problem. Why hide it or continue to feed the addiction without seeking a permanent solution?
 
Are you sure you're posting in the right thread? What you posted seems like nothing to do with the case.
I should have noted my post was like the thread subject, an example of what lawyers do going after corporations. As to the drug issue, IMO, individuals bear most responsibility with substance abuse issues, then doctors providing prescriptions. I just do not have much sympathy for the many humans that lack self control especially those making excuses without admitting any personal responsibility. Two of my remaining 4 brothers are likely to lose their precious life due to liver damage from a lifetime of daily beer drinking with one an added nicotine habit. Much of those prescribed opioid drugs are routed to underground drug dealers. But lawyers going after those two elements would pay out little for the effort and most politicians only choose to hide. Pharmacies historically have not been tasked with evaluating doctor's prescriptions. But now as they with deep pockets, will likely examine subscription databases by person and by doctors in order to find any above unreasonable thresholds.
 
I should have noted my post was like the thread subject, an example of what lawyers do going after corporations. As to the drug issue, IMO, individuals bear most responsibility with substance abuse issues, then doctors providing prescriptions. I just do not have much sympathy for the many humans that lack self control especially those making excuses without admitting any personal responsibility. Two of my remaining 4 brothers are likely to lose their precious life due to liver damage from a lifetime of daily beer drinking with one an added nicotine habit. Much of those prescribed opioid drugs are routed to underground drug dealers. But lawyers going after those two elements would pay out little for the effort and most politicians only choose to hide. Pharmacies historically have not been tasked with evaluating doctor's prescriptions. But now as they with deep pockets, will likely examine subscription databases by person and by doctors in order to find any above unreasonable thresholds.
Apparently you don't have a real understanding of addiction and what happens with a person's brain that causes them to become addicted.

I disagree with your stand and find doctors and pill makers and the drug itself most responsible for people becoming addicted.

Of course once a person is addicted only they can get the help they need to get off them. They often have to have pills for addiction problems to get off of them and it's extremely hard to beat these addictions.


"Addiction is a biopsychosocial disorder. It's a combination of your genetics, your neurobiology and how that interacts with psychological and social factors," said Maureen Boyle, a public health advisor and director of the science policy branch at the National Institute on Drug Abuse. That means it's a lot like any other chronic disorder, such as type 2 diabetes, cancer and heart disease. And just like other chronic diseases, addiction is both preventable and treatable, Boyle said, but added that if left untreated, it can last a lifetime."

Though everyone's path to addiction is different — whether he or she tries a drug or a behavior because it's what that person's parents or peer do, or just out of curiosity — what's common across all substance and behavioral addictions is their stunning ability to increase levels of an important chemical in the brain called dopamine, Boyle told Live Science.


Dopamine is a molecule that ferries messages across the brain's reward center. It's what gives people the feeling of pleasure and reinforces behaviors critical for survival, such as eating food and having sex.



When someone uses a drug or engages in a pleasurable experience, the same natural reward circuitry is activated. "The problem with drugs is that they do the job better than natural rewards," said Dr. Hitoshi Morikawa, an associate professor of neuroscience at the University of Texas at Austin.


Different drugs tap into the dopamine reward system in different ways. Marijuana and heroin have a chemical structure similar to another neurotransmitter and can trick some brain cells into activating neurons that use dopamine. Cocaine and amphetamines, on the other hand, prolong the effect of dopamine on its target neurons, disrupting normal communication in the brain.


How quickly each drug can get into the brain, and how powerfully it activates neural circuits, determines how addictive it will be, Morikawa told Live Science. Some modes of use, like injecting or snorting a drug, make the drug's effects almost immediate. "That's why heroin, for example, is the last drug you want to take," he said. "It's very addictive."

From experimenting to getting hooked​


As individuals continue with addictive habits or substances, the brain adapts. It tries to reestablish a balance between the dopamine surges and normal levels of the substance in the brain, Morikawa said. To do this, neurons begin to produce less dopamine or simply reduce the number of dopamine receptors. The result is that the individual needs to continue to use drugs, or practice a particular behavior, to bring dopamine levels back to "normal." Individuals may also need to take greater amounts of drugs to achieve a high; this is called tolerance.


Without dopamine creating feelings of pleasure in the brain, individuals also become more sensitive to negative emotions such as stress, anxiety or depression, Morikawa said. Sometimes, people with addiction may even feel physically ill, which often compels them to use drugs again to relieve these symptoms of withdrawal. [Booze Snooze: Why Does Alcohol Make You Sleepy, Then Alert?]


Eventually, the desire for the drug becomes more important than the actual pleasure it provides. And because dopamine plays a key role in learning and memory, it hardwires the need for the addictive substance or experience into the brain, along with any environmental cues associated with it — people, places, things and situations associated with past use. These memories become so entwined that even walking into a bar years later, or talking to the same friends an individual had previously binged with, may then trigger an alcoholic's cravings, Morikawa said.


Brain-imaging studies of people with addiction reveal other striking changes as well. For example, people with alcohol-, cocaine- or opioid-use disorders show a loss in neurons and impaired activity in their prefrontal cortex, according to a 2011 review of studies published in the journal Nature Reviews Neuroscience. This erodes their ability to make sound decisions and regulate their impulses.

Risk factors​


Some people are more susceptible to these extreme neurobiological changes than others, and therefore more susceptible to addiction. Not everyone who tries a cigarette or gets morphine after a surgery becomes addicted to drugs. Similarly, not everyone who gambles becomes addicted to gambling. Many factors influence the development of addictions, Boyle said, from genetics, to poor social support networks, to the experience of trauma or other co-occurring mental illnesses.
 
Thanks for your input @Ruthanne that brings a balance to a quite controversial issue. And of course have been quite aware of all this for decades because I've known numbers of acquaintances and relatives with addictions, some sadly all the way to their deaths. Anyone can stop if they have a will too. Unfortunately many do not and are lost in their confused inner world uninterested in listening to others trying to help them much less actually giving up whatever.
 
Same as everybody above. If you are going to drag Pharmacies into court claiming they had a responsibility for the opioid crisis, then why aren't the doctors, who wrote excessive opioid scripts getting sued. Malpractice does have its limits. Filling doctors' prescriptions is a legal business practice. It's the doctors' responsibility for the prescriptions he writes.
 
Another case of finding a scapegoat for our own bad behavior.

I agree that the pharmacists and the health insurance companies should have a system in place to report suspected abuse.

IMO lawsuits like this will increase prescription costs for all of us and make it more difficult for people that need narcotic strength painkillers, but it will do little to prevent drug abuse.
This has already been the result. People with intractable pain from cancer or other conditions should not be forced to suffer unrelenting pain because others abuse the drugs. I know two people right now who are having a hell of a time getting the relief they need. It is unconscionable, in my opinion, to throw everybody in the same pile and force some to endure the unendurable.

Pain doctors and oncologists, for instance, should be allowed to prescribe what their patients require to be comfortable.

I do not think pharmacists should be required to, or allowed to, second guess pain prescription requirements for those with conditions that require them.
 
Same as everybody above. If you are going to drag Pharmacies into court claiming they had a responsibility for the opioid crisis, then why aren't the doctors, who wrote excessive opioid scripts getting sued. Malpractice does have its limits. Filling doctors' prescriptions is a legal business practice. It's the doctors' responsibility for the prescriptions he writes.
And the doctors are a whole lot closer to the patients than pharmacists are. Pharmacists don't examine people.

My hydrocodone dosage was recently slightly increased, and when I went to pick it up my pharmacists came to my window and asked questions. The Rx was already delayed a full day, and still hadn't been filled because the pharmacist was waiting for the doctor to call him back. My explanation made sense and I sat and waited for him to fill it, and that was alright with me. The guy was doing his job.
 
How about when the doc cuts off the pain pills and the patient goes to a street dealer who cuts his heroin with Fentanyl and the patient dies from an overdose? How about those addicted to street opioid drugs? Geez most of the people here are addicted to street drugs and use prescription opioids to get by when their dealer is arrested. The guy's on the street dealing again in no time. Ohio has an illegal drug problem they'd rather not deal with for various reasons, that's my take on this other BS. Only my opinion though.
 


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