BALTIMORE _ Baltimore's law department sued opioid manufacturers and distributors over the marketing of addictive pain pills Wednesday, adding the weight of the Maryland jurisdiction hardest hit by the overdose crisis to the legal campaign to hold the pharmaceutical industry accountable.
In announcing the lawsuit, filed in Baltimore Circuit Court, City Solicitor Andre Davis said he would personally be part of the team handling the case. Davis said the companies marketed the pills knowing they would be "destructive of lives."
"They were reckless, they were intentional, it was marketing, it was greed," Davis said.
The crisis shows no signs of abating, worsening as more drug users are exposed to the potent synthetic opioid fentanyl. More than 3,000 people have died of opioid overdoses in Baltimore since 2007 _ 523 of them between January and September of last year.
The idea of suing pharmaceutical companies over the crisis has gained steam in recent months and several counties in Maryland have already brought similar cases. Anne Arundel County filed a case in state court and Cecil County filed one in federal court. Baltimore County is preparing a suit _ the County Council will vote Monday on a contract to hire a private law firm, with the goal of joining federal litigation in Ohio.
Gov. Larry Hogan has authorized Maryland Attorney General Brian Frosh to bring his own case. Frosh says he is investigating but has too few resources to tackle the full scope of the overdose crisis.
The new Baltimore suit is seeking an order from a judge that the drug companies change how they do business and Davis said any money won by the city would go into municipal coffers as recompense for all the policing and health costs associated with addiction and overdoses.
The Baltimore suit alleges that the drug manufacturers spread false information to doctors and consumers, and funded unscrupulous research that led to biased findings about the dangers of opioid pills. The distributors, meanwhile, are accused of failing to properly report suspicious pill orders as they are required to do under federal and Maryland law.
The city's lawyers say the result was an overdose epidemic in which Baltimore is one of the worst affected places in the nation.
The companies targeted in the case "bear significant responsibility for the epidemic of substance abuse and death that has devastated much of the country."
The defendants in the case are drug makers Purdue, Cephalon, Janssen, Actavis and Endo Health Solutions and distributors McKesson, Cardinal Health and AmerisourceBergen.
Reached for comment Wednesday, representatives for the drug firms denied any wrongdoing and said the companies are committed to making sure that the pills they make or distribute are used safely.
The Baltimore case is unusual because in addition to the large corporations it also targets two doctors who operate a pain clinic with locations in Towson and Owings Mills. The lawsuit alleges that the clinic was a "pill mill" _ an operation that "prescribers controlled dangerous substances without a legitimate medical purpose."
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Dr. Norman B. Rosen, one of the doctors, denied the allegations made by the city and called the charge that he was running a pill mill "absolutely ridiculous."
While he was still on the phone with a The Baltimore Sun Wednesday, Rosen dealt with a television news crew who showed up at his office and called his colleague Dr. Howard Hoffberg and briefed him on what was happening.
"People want a fight, I'll give them a fight," Rosen said.
Reached later, Hoffberg said his lawyers had told him not to make any comment on the case.
"I'm not in any way trying to hide," he said.
At its heart, the case revolves around how dangerous prescription opioids are and what people involved in supplying them to the public knew about the risks.
For his part, Rosen said that, compared to the number of prescriptions written, the number of overdose deaths is very low and that limiting the supply of the pills would hurt people who need help treating their pain.
"The whole opioid crisis is overstated," Rosen said.
When OxyContin, one of the brands of pills, hit the market in the mid-1990s, studies have found it was marketed as not being especially addictive, but for many patients that turned out not to be true.
Relatively few deaths are now directly attributed to overdosing on pain pills, but the widespread prescribing of the drugs has been blamed for turning patients into heroin addicts as they sought ways to handle their cravings.
The chances that the city and other jurisdictions have of succeeding in court remain unclear.
Rebecca Haffajee, who teaches law and public health at Michigan State University, said earlier rounds of personal injury lawsuits found little success. The drug companies were able to argue that individual patients didn't use the pills properly or that doctors had written prescriptions and regulators had signed off on the drugs.
But Haffajee said the cities and counties now suing might have more success. They have the resources to take on a long fight in court and might be able to uncover strong evidence that the manufacturers knowingly minimized the dangers of the pills.
"We've seen a number of settlements that are increasing in frequency," she said.
And while some jurisdictions might be willing to settle cases for cash payments, others could be motivated to see a case through to trial.
"Many are quite aggressive and do want to publicly hold these companies accountable beyond the money," Haffajee said.
