Civil suits will transform the way we understand the problem of opioids

Civil suits will transform the way we understand the problem of opioids
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On May 28, the first major trial targeting opioid manufacturers will start in Oklahoma City. It is just one of 1,880 federal and state civil suits brought by cities, counties, states and tribes targeting the pharmaceutical industry for its alleged role in the nation’s opioid crisis.

These civil cases hope to prove that pharmaceutical companies pursued profits at enormous social costs while leaving communities struggling to contain an epidemic.

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Even before opening arguments begin, the legal discovery process, which is underway in states like Massachusetts and Tennessee, has found evidence of some companies' determination to capitalize on vulnerabilities. 

Some in the pharmaceutical industry allegedly did this by burying mounting evidence of health harms in order to sell what some industry executives labeled “hope in a bottle.”

This crisis has deep roots in deteriorating community conditions, which some drug manufacturers identified and exploited, according to the lawsuits' plaintiffs. The most lucrative markets for opioids were communities where opportunities were drying up and hope was running out; some drug companies took clear advantage of this, according to the plaintiffs, and allegedly singled out veterans, often struggling to reintegrate in society, as a key market. 

The pharmaceutical industry has argued that communities harmed by the opioid epidemic don’t have the standing to sue. Yet the evidence suggests that the industry’s “hope in a bottle” strategy exploited human suffering to sell more suffering — fracturing families, fraying social networks, draining social services and spreading trauma and despair. And as evidence of addiction, overdoses and deaths piled up, one drug maker was reported to have pursued a public relations plan to shift the blame to people harmed by opioids, stigmatizing them as “criminals” and “junkies.”

The trickle of damaging industry documents is likely to soon turn into a flood. With this comes the potential to transform public outrage and policy change.

We have seen industry giants trying to block the release of documents that allegedly expose marketing strategies and efforts to ward off regulations that would have saved lives. On March 4, Reuters reported that one drug maker, Purdue Pharma, may be considering filing for bankruptcy — a move that could put a hold on all active civil cases.

Meanwhile, in the face of a rising backlash in their initial markets — the U.S. and Canada — the pharmaceutical industry is exporting its opioid-marketing strategies to new markets in Europe and Asia. 

We need to get to the bottom of what drug companies may have done to fuel this epidemic, and hold them accountable. That means fully exposing any industry deception, regulatory failures, and negative public health consequences.

This could ultimately harness industry profits to support treatments, as well as prevention. It could also address the very conditions that left communities vulnerable in the first place— giving communities the resources needed to rebuild long-underfunded public health infrastructure.

We also need to address the community-level factors underlying substance misuse and other diseases of despair. This can include the need for stronger social networks, local economic development and living-wage jobs, and opportunities for community members to come together to heal and thrive.

These lawsuits could make a powerful case for stronger government regulation, free from corporate influence, and have the potential to reinforce positive norms and values like corporate responsibility.

Norms matter, and can help protect the social good by constraining and sanctioning bad actors. If powerful industries put profits over health or safety, indifferent to the economic and social costs to communities, we need to push back hard and demand real corporate accountability.

No industry should flourish by making its society sicker. When so many people and communities are getting left behind, we all suffer. We can’t go on living and dying this way — and we don’t have to. Some drug makers sold us “hope in a bottle.” It’s time to reclaim hope for our communities instead.

Sarah Mittermaier and Dana Fields-Johnson work at the national nonprofit Prevention Institute. Mittermaier tracks federal policy on opioids and other issues. Fields-Johnson, as part of her work, supports rural communities in Ohio that have been hard hit by the opioid crisis.