Arkansas Attorney General Leslie Rutledge has sued three drug distributors on behalf of the state, saying they shirked legal responsibilities and fanned the flames of the opioid epidemic.
At a news conference Thursday, Rutledge said she filed suit that morning against wholesale pharmaceutical distributors McKesson Corp., AmerisourceBergen Corp. and Cardinal Health, which also is named in the filing as Cardinal Health 110.
The distributors control about 85% of the national market and "failed to monitor, detect, investigate, refuse and report" unusually high numbers of opioids flowing into the state, Rutledge said, as is their legal duty under 1970's Controlled Substances Act.
"Distributors fueled the explosion of opioids in Arkansas and enabled illegitimate avenues to flourish," she said. "[It's] important that we hold those accountable who have created and [are] contributing to this problem."
Because of their position on supply chains -- sitting between manufacturers and pharmacies -- Rutledge said the companies occupy a place of special responsibility, and were "uniquely positioned to act and prevent an excessive number of drugs from entering our streets."
Instead, she said distributors "flooded" the state with 236 million pills in 2016, or roughly 78 doses for every Arkansan, as the state racked up the nation's second-highest rate of opioid prescriptions during that year.
"There is not one part of Arkansas that has not been hit, whether it's Lake Village, or Gravette, Piggott or Texarkana. ... We want [these companies] to make Arkansas whole," Rutledge said.
AmerisourceBergen and Cardinal Health didn't immediately return messages requesting comment about the lawsuit. A McKesson spokesman said the company did not have a specific comment on the suit but provided a statement about opioids.
"As a company, we are deeply concerned by the impact the opioid epidemic is having on families and communities across our nation," the statement read. "We are committed to engaging with all who share our dedication to acting with urgency and working together to end this national crisis.
"We maintain -- and continuously enhance -- strong programs designed to detect and prevent opioid diversion within the pharmaceutical supply chain."
The distribution companies are based in Dublin, Ohio (Cardinal Health), San Francisco (McKesson) and Chesterbrook, Pa. (AmerisourceBergen), but operate nationally.
An influx of opioid medications in Arkansas contributed to hospital admissions, deaths, high rates of nonmedical use of opioids by teens and a tenfold increase in babies born with neonatal abstinence syndrome, a 41-page complaint associated with the lawsuit says.
Rutledge said the aim of Thursday's filing, which could be amended to add other companies, is to compel distributors to fulfill legal requirements (such as identifying and stopping suspicious shipments) and to hold them financially accountable, though no specific dollar amount is currently sought.
"While these Defendants have reached significant profits, Defendants' failures to prevent the diversion of opioids have contributed to and created a public health crisis of historic proportions," the complaint says.
The filing contends the three distributors violated the Arkansas Deceptive Trade Practices Act, created a public nuisance, breached their duty to exercise reasonable care in distributing addictive drugs, and "unjustly enrich[ed] themselves at the State's expense."
Court documents also cite payments the companies made to the Drug Enforcement Administration and other entities to settle or resolve allegations related to inadequate oversight of opioid prescriptions. In McKesson's case, those payments total $163 million, a filing said.
Arkansas joins 14 other states and one U.S. territory that have filed civil suits against drug distributors in the wake of widespread abuse of opioid medications.
Those localities are Alabama, Alaska, Delaware, Florida, Georgia, Kentucky, Mississippi, New Mexico, New York, Ohio, Rhode Island, Vermont, Washington, West Virginia and Puerto Rico.
In a first-of-its-kind case, New York prosecutors this week additionally announced criminal charges against two former officials at a wholesale pharmaceutical distributor, including conspiring to distribute drugs and defrauding the government, according to reports.
The lawsuit filed Thursday in Pulaski County Circuit Court follows an ongoing 2018 Arkansas suit, also filed by the attorney general, against drug manufacturers Purdue Pharma, Endo, and Johnson & Johnson, all of whom produced opioids.
No investigations of or filings against other health care organizations have been announced by that office, but "nothing is off the table" in the state's "all of the above" approach, Rutledge said.
"We're not going to close any doors, whether it's a specific manufacturer, specific distributors, doctors, whomever in the chain that has increased this problem, this epidemic in our state," she said.
Last year, a group of Arkansas counties and cities also sued dozens of opioid manufacturers and distributors on similar grounds.
In a telephone interview, Arkansas Drug Director Kirk Lane said he'd been briefed on Thursday's filing, which he called "another piece of the puzzle" in fighting opioid abuse.
He said civil suits can help adjust companies' behavior, and that funds obtained in settlements or judgments can be routed back into communities to repair part of what has been lost.
"Some of the damage and death and destruction that has gone [on] across Arkansas and the rest of the nation, I don't know how they undo that," he said.
Lane was traveling back from the National Prescription Drug Abuse and Heroin Summit in Atlanta, where he estimated 3,000 had gathered to discuss topics such as opioid abuse and overdose deaths, which continue to be reported across the United States.
In 2017, overdoses involving opioids killed 47,600 Americans, 188 of whom were Arkansans, according to information compiled by the National Institute on Drug Abuse.
The problem is thought by some researchers to have contributed to an overall decline in American life spans.
Both state and local public health and law enforcement agencies have continued to roll out a variety of initiatives intended to combat the issue.
Also on Thursday, the federal Food and Drug Administration unveiled a new campaign to encourage the safe disposal of opioid medications, and earlier this week the White House touted the work of President Donald Trump's administration on the cause.
That has included a fourfold increase in U.S. Department of Health and Human Services grant funding and a boost to state opioid response grants, a White House statement said.
In March, the Health and Human Services Department announced Arkansas would received more than $2 million in supplementary opioid response funds this year.
Rutledge said that during a visit to Washington, D.C., last month, Trump specifically commended Arkansas' work on opioids, including her "Prescription for Life" education program, the lawsuit against manufacturers and local drug take-back drives.
The state's next drug take-back drive is scheduled for Saturday.
Metro on 04/26/2019