Two rural Kentucky health clinics are trying to open a new front in the legal battle against drug companies that allegedly used improper tactics to fan an epidemic of addiction to powerful painkillers called opioids.
The clinics allege in a federal lawsuit that they have faced uncompensated costs — and will face more — for treating people who became drug abusers in an epidemic “created and engineered” by drug companies.
“These pharmaceutical companies aggressively advertised to and persuaded practitioners to prescribe highly addictive, dangerous opioids, and turned patients into drug addicts or dependents for their own corporate profit,” the complaint charges.
The clinics are Family Practice Clinic of Booneville, Inc., and Family Health Care Clinic, PSC, in Madison County.
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Their lawsuit lists more than 20 defendant pharmaceutical manufacturers and distributors. Some of the companies are subsidiaries of others in the complaint.
Three attorneys with the Lexington firm of McBrayer, McGinnis, Leslie & Kirkland, along with a firm from Georgia, filed the lawsuit for the clinics.
However, the lawsuit by the Madison and Owsley County clinics, filed Wednedsay in federal court, is believed to be the first such complaint by rural health clinics, said David J. Guarnieri, one of the Lexington attorneys handling the case.
The lawsuit seeks class-action status on behalf of rural health clinics. If a judge approves the request, the complaint says there are more than 4,100 rural health clinics in the U.S that would be in the class.
It also identifies two potential sub-classes: 745 rural clinics in Appalachian areas of Kentucky, Alabama, Mississippi, North Carolina, Ohio and Tennessee; and 191 clinics in Kentucky.
“They’re on the front lines dealing with the opioid crisis,” Guarnieri said of rural clinics.
The lawsuit argues that drug makers used false and misleading claims to push their products, such as down-playing the risk of addiction; claiming that it is easy to manage opioid dependence and withdrawal; and denying risks from using higher doses of the drugs.
For instance, one company distributed a guide that described the claim that opioids are addictive as a “myth,” and the industry “trivialized” the risks of long-term opioid use, the lawsuit says.
In fact, the federal Centers for Disease Control and Prevention said in a 2016 guide that opioid pain medicine presents serious risks and that using the drugs for three months “substantially increases risk for opioid use disorder,” according to the lawsuit.
The complaint says drug makers targeted susceptible prescribers as part of their scheme, including primary care doctors who were “less likely to be educated about treating pain and the risks and benefits of opioids.”
It also alleges the companies targeted vulnerable patient populations, including people served by rural health clinics in Appalachia.
There is a high prevalence of “societal risk factors which contribute to an increased and widespread abuse of opioids” in the region, the lawsuit says, including lower income; lower educational attainment; depression; a higher portion of jobs prone to injuries; and poor health status.
Drug distributors added to the problem by failing to stop suspiciously large shipments of painkillers and by not reporting red flags about possible diversion of prescription pills to the government as required, the lawsuit says.
The improper conduct has played a role in rising abuse of heroin because when addicts can’t get painkillers legally, they often buy pills on the street or turn to heroin, the lawsuit alleges.
Opioids were to blame for two-thirds of the more than 63,000 drug-overdose deaths in the country in 2015, according to federal reports.
The drugs also played a major role in Kentucky’s record 1,404 fatal drug overdoses in 2016.
The lawsuit says opioid addiction drives up costs for rural health clinics, not just for providing treatment but for added needs such as regulatory compliance and security; lost employee productivity; and having to kick out patients for abusing or diverting prescribed drugs.
The clinics don’t get back the full cost of treating people, and will face increased costs going forward to deal with the fallout from addiction even if the crisis abates, the lawsuit says.
The lawsuit seeks unspecified damages to compensate clinics and punish the companies.