SALT LAKE CITY — Salt Lake County filed a lawsuit Tuesday against pharmaceutical companies and medical professionals, alleging the scourge of opioid addiction in the county "stems directly from a callously deceptive marketing scheme that was spearheaded by certain opioid manufacturers and perpetuated by prominent doctors they bankrolled."
That alleged scheme, according to the 97-page complaint the county filed in 3rd District Court, "has exacted a foreseeable financial burden on Salt Lake County," which has spent millions of dollars "on addiction treatment and other programs aimed at curbing the crisis" of opioid addiction.
"Our jail facilities, our public health facilities, our community treatment centers, our youth treatment centers' resources are all being overburdened and overwhelmed," said Salt Lake County District Attorney Sim Gill during a press conference Tuesday announcing that the lawsuit had been filed.
"And they require a further investment from our community and our tax dollars as we struggle to meet this overwhelming need of (addiction) treatment now for our citizens and into the future. ... The enormous burden on the taxpayers should not — will not — be borne by Salt Lake County's taxpayers alone," Gill continued.
He later added, "What we're really saying is enough is enough."
With the filing, Salt Lake County becomes the third county in the state to sue pharmaceutical companies this year over of the accusation that manufacturers and marketers of prescription opioids have long deceived the public about the risks inherent in their products.
Aim of the lawsuit
Gill wouldn't comment on precisely how much money the county could seek in the lawsuit, except to estimate it would "go into the millions of dollars." Damages received would go toward helping the county fight the opioid crisis using a "therapeutic justice model," he said.
Asked what the strategy is behind the county's decision to file its own lawsuit, Gill responded that "the emphasis here is to recognize this problem has bled down to a local level."
"We have a unique story to tell, that is unique to us," he said. "We couldn't wait for the state. We have the legal authority and independence to (sue)."
Utah Attorney General Reyes said in January that Utah is participating in a 41-state push to negotiate a settlement with opioid makers and is preparing to sue if the terms of an agreement reached in that effort are unsatisfactory.
"Should we feel that at any time during the process leading up to settlement that the manufacturers and distributors aren't cooperating with the states, then we wanted to have the gun loaded, figuratively, ready to pull the trigger on a lawsuit," Reyes told reporters in January.
With only one dissenting vote, state lawmakers passed a nonbinding resolution last month that urges Reyes to "immediately and publicly commit to directly filing suit against prescription opioid manufacturers, instead of joining a suit with other plaintiffs, in order to seek the maximum award for damages from prescription opioid manufacturers for the citizens of the state."
House Speaker Greg Hughes, R-Draper, has vocally urged the same of Reyes and of each county statewide.
Gill's office hired several outside attorneys from multiple law firms to handle the case, including former Arizona Attorney General Grant Woods. Gill said he did so because "this is a national issue. We need people who have the subject matter expertise, (who are) what I call our all-star team."
Woods told reporters Tuesday that there's reason to believe curbing opioid addiction could be as successful as efforts to hamper the tobacco industry and reduce substance dependence across the country.
"It's a lofty goal. We want to solve the opioid problem in the United States and in this county. I think we can do it," he said.
Woods praised Gill for filing the lawsuit, saying "It takes some courage to take on the big guys."
"I don't have much sympathy for them. … They need to pay the price here. And we're going to make them pay the price," Woods said. "We're confident that we'll win our case. If they want to resolve it, they can resolve it, but they're going to have to be serious about it."
Defendants push back
Defendants listed in the lawsuit, some of them under the names of multiple entities that make up different parts of their wide-reaching business operations, include Purdue Pharma, Janssen Pharmaceuticals, Endo Pharmaceuticals, and pharmaceutical organizations Allergan and Actavis. Dr. Lynn Webster and Dr. Russell Portenoy are the two named individual defendants in the complaint.
Johnson & Johnson, a parent corporation to Janssen Pharmaceuticals, is also named as a defendant.
A handful of the defendants responded Tuesday in emails to the Deseret News.
"We are deeply troubled by the prescription and illicit opioid abuse crisis, and we are dedicated to being part of the solution," Purdue Pharma said in a statement. "As a company grounded in science, we must balance patient access to FDA-approved medicines, while working collaboratively to solve this public health challenge."
The statement from Purdue Pharma said the company "developed three of the first four FDA-approved opioid medications with abuse-deterrent properties" and that it has worked with police to ensure better access to the overdose reversal drug naloxone. The company's statement didn't specifically address the allegations in the lawsuit.
Allergan said in a statement that its three opioid products "account for less than 0.04 (percent) of all opioid products prescribed in 2017 in the U.S." The company called the products "legacy acquisitions" and said that they "have not been promoted" — one of them since 2013, and the other since 2003.
"Allergan has a history of supporting — and continues to support — the safe, responsible use of prescription medications," the company said in a statement. "This includes opioid medications, which when prescribed and used responsibly, play an appropriate role in pain relief for millions of Americans."
Janssen Pharmaceuticals spokeswoman Jessica Castles Smith said in a statement that "Our actions in the marketing and promotion of these medicines were appropriate and responsible."
"The labels for our prescription opioid pain medicines provide information about their risks and benefits, and the allegations made against our company are baseless and unsubstantiated," Smith said. "In fact, our medications have some of the lowest rates of abuse among this class of medications."
Efforts to reach the other defendants for comment were not immediately successful.
Webster defended his own promotion of opioids in an in-depth article about painkillers that the Deseret News published in October 2017.
"Almost all of what you hear about today is about the harm of opioids. And there is a lot of harm. It's tremendous, it's terrible," Webster said then. "But in that narrative the people in pain are being forgotten."
Magnitude of addiction
But Salt Lake County Mayor Ben McAdams contends that what opioid companies have forgotten is the plight of an unthinkably high number of Utahns whose lives have been ruined by addiction — whether by their own dependence, or that of a loved one.
"Every family is touched by the greed and the harm that has been perpetrated by individuals looking to make a profit off of opioids," McAdams told reporters.
The mayor said that opioid addiction kills more people in the United States under the age of 50 than anything else. In Salt Lake County, he said, the need for addiction treatment is overwhelming.
"Every treatment bed we're able to open is immediately filled," McAdams said.
The lawsuit details many of the opioid statistics that Gill, McAdams and other public officials say they find appalling. Among them are the studies that show nearly 80 percent of heroin addicts first got hooked on prescription opioids, a number that McAdams said has been determined to be even higher among the indigent population in the Rio Grande neighborhood of downtown Salt Lake.
"The pathway is through prescription medicine," Gill said.
Gill also said almost 60,000 people currently could stand to benefit from opioid addiction treatment in some form or another in Salt Lake County.
"The numbers are striking," the lawsuit states. "Nearly half of all fatal opioid overdoses in Utah annually occur in Salt Lake County; here, 531 opioid overdoses occurred in 2014 (and) 2015 alone — roughly one every 33 hours."
Gill also said that prescription rates in Salt Lake County are higher than the state average almost every year.
The magnitude of the burden in dealing with widespread addiction, and "the devastation it has caused to the infrastructure of Salt Lake county," Gill said, are ultimately the driving reason behind his desire to hold pharmaceutical companies and others accountable.
Part of the strained infrastructure is the county jail, Salt Lake County Sheriff Rosie Rivera said Tuesday. The number of arrested drug abusers has ballooned in recent years, she said, severely burdening the facility.
"Our jail staff spend up to six hours per day just to provide treatment and care for drug users who are going through withdrawals," Rivera said.