American pharmacies face trial in Ohio over role in opioid crisis

A key opioids trial — the first to go to federal court — began this week in Ohio. The trial focuses on questions of accountability and responsibility for the opioids crisis, which has been connected directly with the deaths of half a million Americans. William Brangham has the latest with National Public Radio’s Brian Mann.

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  • Judy Woodruff:

    A closely watched opioids trial began this week in Ohio, the first to go to federal court. The trial focuses on questions of accountability and responsibility for the opioids crisis, which has been connected directly with the deaths of half-a-million Americans.

    William Brangham is here with the latest.

  • William Brangham:

    This trial focuses on four pharmacy chains, CVS, Walgreens, Walmart and Giant Eagle, and the millions of pain medications that were prescribed through their facilities.

    Two Ohio counties, Lake and Trumbull, which are both near Cleveland, allege that, between 2006 and 2014, these companies recklessly dispensed opioid prescriptions and ignored clear warning signs as people became increasingly addicted.

    Brian Mann covers addiction for NPR, and he's been in Cleveland covering this trial.

    Brian, thank you so much for being here.

    Could you just tell us a little bit more? What is the main argument that these counties are making?

  • Brian Mann, National Public Radio:

    Basically, the idea is that, under the Controlled Substances Act, federal law requires pharmacies, like other businesses that handle these really risky opioids, to do so super cautiously, to make sure that the pills go to the right people, to look at prescriptions that come in from doctors and think about whether these are proper prescriptions.

    And what the counties say is that, rather than doing that kind of diligence, these companies just kept funneling pills out the door, and that a lot of people got hurt as a consequence. What they're supposed to do is call the Drug Enforcement Administration, call local law enforcement if they feel like that there's a serious sort of drug-dealing situation that goes on.

    And the pharmacy chains can point to cases where they did do that. But there are also many instances that are already coming forward in this trial where doctors who had really suspicious track records kept sending patients to these pharmacies, and the pills kept going out the door.

  • William Brangham:

    So, that's, I guess, part of the pharmacies' argument, that, we did do some of this.

    But they're — I know that they're pointing the finger elsewhere as well. What's the rest of the argument that they make?

  • Brian Mann:

    What the pharmacy chains basically say is that the deciders, the decision-makers, were elsewhere.

    One of the attorneys has already come forward for the pharmacy chains and said, look, it's up to the doctors how many pills got distributed, not just here in Lake and Trumbull County, Ohio, but all over the country. Doctors started prescribing more and more of these pills. They say, that's not our fault.

    And so, again, that's what these jurors are going to have to parse out. It's a complicated trial. They're going to have to decide whether these pharmacy chains played some significant role in creating this epidemic which has killed hundreds of thousands of Americans.

  • William Brangham:

    And, as you have well reported, continues to this day.

    I understand that some internal documents from these pharmacy chains have come to light, as well as in your own reporting. You got some internal documents where it seemed employees were raising red flags internally.

    Can you tell us what those documents showed?

  • Brian Mann:

    Yes, this is really troubling.

    Already, at this trial, documents from CVS and Walgreens have been entered into the record that suggest that employees of these pharmacy chains were saying to corporate executives, look, we're worried by what we're seeing. We're not sure that we're doing enough. We think that some orders are coming in that could wind up with these powerful addictive pills being diverted and abused.

    And I should say that NPR's own investigative reporting has found pharmacists at Walmart in particular who say over and over we tried to reach out to corporate executives, we tried to warn them that this was going wrong, and we were silenced or we were ignored.

  • William Brangham:

    I know this is still somewhat early days, but you have been watching a lot of this litigation in different jurisdictions around the country for a couple of years now.

    Do you have a sense, does this seem like a strong case that the counties have that they're making?

  • Brian Mann:

    On one level, there's sort of a commonsense question: How did this make sense? Why, at a time when addiction rates and overdose deaths were surging, why did this just keep happening?

    At the same time, some of the legal arguments being made here are new. That's why this is a test case that's going to resonate all over the United States. More than 3,000 governments like Lake and Trumbull County have filed similar lawsuits saying that these corporations contributed to what's technically called a public nuisance. That's how they're defining this opioid epidemic in legal terms.

    If these corporations are found liable, they're going to have to pay billions of dollars to help clean up that public nuisance. But, again, under civil law, this is still kind of untested territory. So we're just going to have to see. What happens here really is going to be precedent-setting.

  • William Brangham:

    And, lastly, if these counties prevail, what do they say they want this money for?

  • Brian Mann:

    You know, it's interesting. In reporting on this, this is something I try very hard to make clear that this isn't just legal mumbo jumbo. This isn't just corporations fighting in civil courts.

    This is life-and-death stuff. The question of how much money companies may have to pay if they're found liable relates directly to how much drug treatment, addiction treatment, health care programs can go on in communities all over the United States.

    And this is happening in a year when overdose deaths are expected to top 100,000 fatalities for the first time in American history. This is a devastating, ongoing crisis. There is not enough addiction treatment out there. And so that's what these counties say. We will put this — this is them speaking here. They say, we will put this money directly into keeping people alive.

    And so that's what's on the line here. That's one of the questions being asked is, how much resource and dollars will go out to communities that are seeing this spike in deaths right now?

  • William Brangham:

    All right, Brian Mann of National Public Radio, thank you very much for sharing your reporting with us.

  • Brian Mann:

    Thanks for having me on.

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