California counties join nationwide lawsuit against opioid manufacturers

SAN FRANCISCO -- Marin is the latest California county to take legal action against opioid manufacturers and distributors, accusing the companies of falsely promoting the safety and efficacy of addictive prescription painkillers and contributing to the opioid epidemic.

The move comes a day after 30 California counties, which represent 10.5 million Californians, joined a similar but separate lawsuit against drug companies over the opioid crisis.

McKesson, a pharmaceutical distributor headquartered in San Francisco whose role in the opioid crisis has drawn attention, was among the companies sued.

The suits will likely be combined and included in the ongoing nationwide opioid litigation in federal court in Ohio, where more than 500 public entities have lodged similar complaints.

Contra Costa was the only Bay Area county to participate in the 30-county lawsuit filed Tuesday in U.S. District Court for the Northern District of California. Marin County filed a separate suit in the same court against the drug companies Wednesday.

The other counties are primarily in the state's northern and central regions, including Sacramento, Fresno, Mendocino and Monterey counties, according to John Fiske, a San Diego lawyer whose firm Baron & Budd is representing 300 public entities suing the drug manufacturers, including the California plaintiffs.

In Contra Costa County, 5 percent of the population aged 12 and older -- about 54,000 people -- misused opioids in 2016, the complaint says. About 1 percent, or 9,700 people, have an opioid use disorder.

In Marin County, drug overdoses are the leading cause of accidental deaths, surpassing motor vehicle accidents. In 2016, the last year for which data is available, 14 people died from opioid overdoses, according to figures compiled by health regulators. The county has the second-highest rate of opioid overdose deaths, in proportion to its population, among the nine Bay Area counties.

Statewide, about 2,000 people died from opioid overdoses in 2016, the last year for which data is available. Nationally, opioid overdoses accounted for 42,000 deaths in 2016, more than any other year on records, according to the U.S. Department of Health and Human Services.

Besides McKesson, the lawsuits name AmerisourceBergen Corp., Cardinal Health, Endo International, Insys Therapeutics, Janssen Pharmaceuticals, Mallinckrodt, Purdue Pharma, Teva Pharmaceutical Industries, Johnson & Johnson, Noramco and Allergan.

The complaint accuses the companies of aggressively marketing and promoting opioid prescribing as having little or no risk of addiction, encouraging doctors to treat chronic pain with opioids, and improperly distributing large volumes of pills to communities throughout the United States.

It seeks repayment of public tax dollars that counties have spent responding to opioid addiction, such as jail beds and hospital spending. It also seeks to create a fund that would pay for addiction prevention and rehabilitation programs. Attorneys for the counties have not yet determine a dollar amount for the payments, Fiske said.

McKesson declined to comment about the pending litigation but in a statement said the company is ``deeply concerned by the impact the opioid epidemic is having on families and communities across our nation. We are committed to engaging with all who share our dedication to acting with urgency and working together to end this national crisis.''

Executives for McKesson, Cardinal and AmerisourceBergen testified before a House subcommittee Tuesday to answer lawmakers' questions about their role in the opioid crisis. Some executives outlined steps they say their companies are taking to address opioid abuse.

``There is no question that beginning more than a dozen years ago, and continuing to this day, physicians have prescribed large numbers of opioids to millions of Americans for a wide range of conditions,'' McKesson CEO John Hammergren wrote in his prepared statement to the House Energy and Commerce subcommittee on oversight and investigations. ``This is part of a major public health crisis in this country, a root cause of which is the over-prescribing of opioids.''

Legal expert say lawsuits this complex --involving hundreds of cities and counties and dozens of corporate defendants -- usually end in large settlements. Some observers compare its scope and scale to litigation against tobacco companies in the late 1990s that resulted in the largest settlement in U.S. history, of more than $200 billion.

The plaintiffs in the opioids case are testing a new legal theory against drug distributors that has not been tried before in the courts, said Adam Zimmerman, a law professor at Loyola Law School who specializes in complex litigation.

``The theory against distributors is novel because they're saying, 'You were in a position to see this problem and you're not doing anything about it' '' Zimmerman said.

In a separate lawsuit filed in state court in 2014, Santa Clara and Orange counties are pursuing similar claims of deceptive marketing against five opioid manufacturers -- Purdue, Johnson & Johnson, Teva, Endo and Actavis. The lawsuit is ongoing and could go to trial as early as June 2019.