Ohio state flags waving in front of the Ohio State House

Ohio’s Efforts to Centralize Control Over Opioid Claims

By Daniel Aaron

On October 21, two Ohio counties are slated to present their opioid claims in a federal trial. However, last week, 13 states and the District of Columbia signed onto a brief requesting that the 6th Circuit Court of Appeals stay the upcoming trials. Their reasoning? States should control lawsuits for harms within the state; cities and counties do not have authority to sue on their own. While it makes sense that Ohio’s attorney general, spearheading this effort, would want more power and control over opioid claims, the move has the potential to harm public health by disempowering local governments from addressing public health crises. Ohio’s three main arguments will be discussed in turn.

Argument 1: Violation of State Sovereignty

First, Ohio argues that the county lawsuits violate state sovereignty and disrupt the “federal dual-sovereign structure” of the United States:

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Black and white photograph of a gavel in front of scales of justice

Big Ruling in Philadelphia: The Controlled Substances Act does not forbid a safe drug consumption room

By Scott Burris

Federal District Judge Gerald McHugh of the Eastern District of Pennsylvania ruled today that the operation of a safe injection site to prevent overdose, HIV, and other harms associated with drug injection would not violate the federal Controlled Substances Act.  The ruling came in an action for declaratory and injunctive relief brought by the local U.S. Attorney, seeking to prevent the opening of “Safehouse” by a private group led by former Pennsylvania Governor and Philadelphia Mayor Edward G. Rendell. The judge denied the requested relief.

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Photograph of Purdue Pharma headquarters

The Role of Attorneys General in the Opioid Litigation

By Daniel Aaron

People following the opioid lawsuits might have noticed some strange headlines as of late. Virtually every state’s attorney general (AG) is suing Purdue Pharmaceuticals, maker of the blockbuster drug OxyContin. Purdue filed for bankruptcy and is hoping to settle for “$10 billion.” However, the deal only includes $4.4 billion in cash, which is less than the Sackler family, owners of Purdue, transferred to personal accounts over the past decade. In other words, the amount of money the Sacklers made from the opioid epidemic is more than what they will pay more than forty states to help abate the crisis. Is anyone supporting this deal?

Yes, in fact, and this is where the plot thickens. With several exceptions, support for the deal falls along party lines: Republican AGs support the deal, and Democratic AGs oppose it. Why does a decision about settling with an opioid company appear to be political? What is the role of an attorney general? And are they supposed to defend public health?

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Photograph of a gavel and three open books

Monthly Round-Up of What to Read on Pharma Law and Policy

By Ameet Sarpatwari, Charlie Lee, Frazer Tessema, and Aaron S. Kesselheim

Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues relevant to current or potential future work in the Division.

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3-D rendering of an HIV virus

Not Another Scott County?

By Emily Beukema, Aila Hoss, and Nicolas Terry

In November 2014, Scott County, Indiana was the site of a now infamous HIV outbreak linked to intravenous drug use. Syringe service programs (SSP) would not only have curbed that outbreak but also could have prevented it from occurring in the first place. Later analysis found that then Governor Pence of Indiana failed to declare a state of emergency until two months after the peak infection rate and that, even after that declaration, disagreements among stakeholders later delayed the implementation of a temporary SSP. Absent those delays the number of infections could have been dramatically decreased.

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Rachel Rebouché and Scott Burris on “The Week in Health Law” Podcast

By Nicolas Terry

Two great guests this week, Rachel Rebouché and Scott Burris, both from Temple Law School in Philadelphia. We’re here not only to tease Temple Law’s 2019 Law Review Symposium: Looking Back and Looking Ahead, 10 Years of Public Health Law Research, Friday, September 13, 2019, but also to discuss some cutting edge issues in public health responses to the opioids overdose crisis and the erosion of reproductive rights. Scott, of course, is a Professor of Law at the law school, where he directs the Center for Public Health Law Research. He is also a Professor in Temple’s School of Public Health.  Rachel is a Professor of Law at Temple and also serves as Associate Dean for Research. She teaches Family Law, Health Care Law, and Contracts and is currently a co-investigator on two grant-funded research projects related to reproductive health.

The Week in Health Law Podcast from Nicolas Terry is a commuting-length discussion about some of the more thorny issues in health law and policy. Subscribe at Apple Podcasts or Google Play, listen at Stitcher Radio, SpotifyTunein or Podbean, or search for The Week in Health Law in your favorite podcast app. Recent episodes are also available on YouTube.

Show notes and more are at TWIHL.com. If you have comments, an idea for a show or a topic to discuss you can find me on Twitter @nicolasterry and @WeekInHealthLaw.

Subscribe to TWIHL here!

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Jenn Oliva on “The Week in Health Law” Podcast

The Oklahoma opioid verdict was handed down on August 26 and, of course, there’s only one person to discuss it with, Jennifer OIiva. Professor Oliva is on the faculty at  at Seton Hall Law where she specializes in health, FDA, and evidence law. An honors graduate of Georgetown University Law Center, Professor Oliva was a Public Interest Law Scholar and served as Executive Notes & Comments Editor of The Georgetown Law Journal. After law school, Professor Oliva clerked on the 10th and 3rd Circuit court of appeals. She also served as the Deputy State Solicitor of the State of Delaware. Read her smart scholarship here.

The Week in Health Law Podcast from Nicolas Terry is a commuting-length discussion about some of the more thorny issues in health law and policy. Subscribe at Apple Podcasts or Google Play, listen at Stitcher Radio, Spotify, Tunein or Podbean.

Show notes and more are at TWIHL.com. If you have comments, an idea for a show or a topic to discuss you can find me on Twitter @nicolasterry and @WeekInHealthLaw.

Subscribe to TWIHL here!

swarm of media and tv cameras

The Hidden Cost of Misinformation: Harms from Opioid Hysteria Extend Beyond Overdose Deaths

Fentanyl is a potent opioid analgesic and has been the center of the opioid and overdose epidemic. As an illicit agent, fentanyl is often in the form of a powder, which is then either insufflated (the fancy medical term for snorting) or dissolved in water and injected intravenously. It is fifty to one-hundred times more potent than heroin, the drug it replaced as the illicit opioid of choice. It can cause significant euphoria and analgesia, which is why it is so widely used. It can also cause respiratory depression or complete respiratory arrest, the reason it can be so deadly. It is readily absorbed when insufflated or injected and the actions are almost immediate. These are the facts.

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pills

More Opioid Litigation Shoes Dropping: Everywhere But Cleveland!

By Jennifer Oliva and Nicolas P. Terry

The much publicized settlement between Purdue Pharma, its Sackler family owners, and the Oklahoma attorney general that we have discussed here, here, and here, posed an overarching question: Post-Oklahoma, would the opioid litigation center of gravity swing back from the states to the federal opioid multidistrict litigation in Cleveland (discussed in detail here)?

A month later, the Cleveland case remains muted, particularly so for the reporters trying to cover what is happening in Judge Polster’s courtroom where, once again, sunshine seems discouraged. In contrast, outside the Northern District of Ohio, the action has been fast and furious and that’s before the promised Oklahoma trial against the non-Purdue defendants.

Speaking of settlements, West Virginia, the state with the highest drug overdose rate in the United States, settled its claims against “Big Three” drug distributor McKesson Corporation for $37 million on May 2. West Virginia had accused McKesson (America’s largest drug distributor and seventh on the 2019 Forbes Fortune 500 list with an annual revenue north of $208 billion), of negligently flooding the state with prescription opioids.

West Virginia’s complaint against McKesson was damning, alleging, among other things, that the drug distributor sent approximately 1.4 million prescription opioids or 118 opioid painkillers per resident to modestly-sized Grant County, West Virginia alone over a five-year period. Read More

A bottle of spilled prescription pills and bottle on a black background

Public Health Law Watch Files Amicus Brief in Opiate MDL

By Faith Khalik

On May 3, 2019, Public Health Law Watch and six other amici filed an amicus brief in the national prescription opiate litigation in the northern district of Ohio.

During the case’s first hearing in January 2018, Judge Dan Aaron Polster told lawyers that he expected to see a settlement that would reduce the adverse public health impact of the opioid crisis, instead of just “moving money around.” The amicus brief submitted by PHLW et al. proposes just that: a settlement that includes a framework for addressing the opioid crisis and has a meaningful positive impact on public health.

Specifically, the brief proposes the creation of a nonprofit foundation to monitor the settlement’s implementation, participate in development and implementation of evidence-based programmatic initiatives, and administer funding for local treatment and prevention resources.

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