The increase of opioid addiction has affected Johnson County just as it has other Texas counties and other states, Johnson County Judge Roger Harmon and Commissioner Rick Bailey said.
“The main thing is it’s had tragic consequences for many of our citizens,” Bailey said. “It’s also, from a county perspective, affected our indigent defense and healthcare funds and MHMR.”
The county on Monday filed suit in the 18th District Court against New York pharmaceutical Purdue Pharma and numerous other pharmaceuticals who manufacture and sell opioids. Also named in the suit are CVS Health, Walgreens, Wal-Mart and Dr. John T. Dang of Cleburne.
The suit alleges that the “widespread use of opioid drugs” is the direct result of a concerted industry scheme.
“The defendants and their affiliates successfully created a market for these products by identifying and expanding new market for these products relying on false science, which was frequently the work of their own product champions enlisting either unwitting or complicit health providers as their advocates and accomplices and saturating the direct consumer market with false advertising, promotions and reassuring messages all of which were calculated to cause and did cause consumers in Johnson County to seek out these medications,” according to the suit. “In short, these defendants expanded the market for opioids beyond that for which it was originally intended and created a disaster of gargantuan proportions, the likes of which has never been seen in the pharmaceutical industry.”
The opioid crisis affects urban and rural residents, men and women, all ages, races and socioeconomic groups, according to the suit.
“This is not a class action suit,” Harmon said. “But we are connected to many other Texas counties and other states who are also suing.”
The suit seeks damages in an amount to be determined by a jury of more than $1 million but less than $100 million.
Drug overdoses are the leading cause of accidental deaths in the U.S. and of the 54,404 lethal overdoses in 2015, 20,101 were credited to pain relievers and 12,990 to heroin, according to the suit.
Everyday 91 Americans die from opioid overdoses, according to the suit.
Johnson County sits historically above average in opioid prescription rates, according to the suit.
“The vast majority of drug users and abusers — 94.52 percent — need addiction treatment but receive none, and a quarter of these patients have no health insurance, thereby imposing a huge healthcare burden on the county and its residents,” according to the suit.
The rate of overdose deaths in Johnson County increased from 4.1 percent to 6 percent per 100,000 residents in 1999 to 12.1 percent to 14 percent per 100,000 in 2015.
“The abuse of prescription opioids has contributed to another unfortunate, but foreseeable, phenomenon: the increase in the use of recreational opioids, namely heroin,” according to the suit. “Many patients who are prescribed opioids for medical purposes become addicted and believe they have no alternative but to turn to illegal opioids. The inevitable result of this drastic increase in the use of heroin has been a commensurate increase in heroin-related deaths, as with other opioids.”
Johnson County Stop the Offender Special Crimes Unit Commander Larry Sparks said the percentage of heroin seizures have increased.
Sparks, who has no direct connection to the county’s suit, called prescription drug abuse the country’s biggest problem drug wise.
“Most of these people started using opioids for legitimate medical purposes and then became addicted,” Sparks said.
Other issues include doctor shopping, whereby individuals receive prescriptions from multiple doctors, purchasing opioids online on the dark web and an increase of home burglaries targeting prescription drugs.
“Research shows that approximately 80 percent of people who use heroin first misused prescription opioids,” according to the suit.
An estimated 254 million opioid prescriptions were filled in 2010 and pharmaceutical companies realized revenues of $11 billion form opioid sales alone that year, according to the suit.
Documents show that the pharmaceuticals sought to avoid scrutiny of the dangers of opioids by employing “seemingly independent third-party healthcare organizations to promote the use of these drugs,” according to the suit.
The organizations, however, were “nearly fully funded” by the pharmaceuticals to “distribute false information regarding the dangers of abuse and addiction historically associated with these drugs.”
The Texas Medical Board temporarily suspended Dang’s medical license in April pending further orders from the board on allegations of prescribing dangerous drugs and/or controlled substances to one patient and sexually assaulting two other patients among other allegations.
Dang, who closed his downtown Cleburne clinic the same day of the suspension, remains under investigation on the charges.
The county’s suit against Dang focuses solely on the alleged illegal prescriptions.
“Dr. Dang created a public nuisance through the issuing of prescriptions outside the usual course of practice and for other than a legitimate medical purpose,” according to the suit. “Such dispensing was performed primarily for monetary gain and provides ample evidence of a conspiracy to profit from a known public nuisance.”
The suit also accuses the named pharmaceuticals and drug stores of public nuisance by “acting in concert to achieve a common objective.”
The suit also alleges civil conspiracy on the defendant’s parts.
“Defendants coordinated their efforts to create a market for their opioid medications through industry-created misperception of the benefits and risks of these drugs. This common behavior was illegal and tortuous in many respects and was a direct cause of the propagation of both legal and illegal opioid drug use.”
Negligence is also alleged.
“Defendants failed to properly train or require employees and affiliates to identify, report and investigate any improprieties in the flow of opioids,” according to the suit. “As a proximate result, defendants have caused Johnson County to incur excessive costs to treat the opioid epidemic including but not limited to increased costs of social services, health systems, law enforcement, judicial systems and treatment facilities.”