The opioid epidemic

BRATTLEBORO — The select board on Tuesday voted to file a lawsuit against pharmacy chains, pharmacy benefit managers, and manufacturers and distributors of opioid painkillers, accusing them of fueling the drug crisis that caused 24 deaths in Windham County last year.

Brattleboro will join more than 1,000 local governments around the country, including Keene and Cheshire County, that have filed similar suits.

The select board also voted to opt out of a national “negotiating class” of cities and counties formed for the purposes of pursuing a global settlement of opioid litigation that has been or could be brought by those governments. That means Brattleboro will go to trial or settle its lawsuit separately, rather than being bound by whatever agreement the negotiating class reaches.

Brattleboro officials are modeling their lawsuit on one filed by Bennington, Vt., according to statements at Tuesday’s meeting. The Bennington lawsuit names as defendants dozens of companies and individuals. It accuses manufacturers of pushing highly addictive painkillers on the market despite knowing the risks, and alleges pharmacies and distributors failed in their duty to monitor and control suspicious orders, which were then diverted for illicit use.

While Brattleboro’s lawsuit will include pharmacy chains that have locations in town, the select board unanimously agreed not to name locally owned pharmacies as defendants. Members of the board said the Bennington complaint cites specific evidence of negligence on the part of national chains, but they did not feel they had any such evidence for the local businesses.

“What we know from this information is that the national chains engaged in these practices,” select board member Elizabeth McLoughlin said, according to a video of Tuesday’s meeting. “We don’t know that the local pharmacies did.”

The companies have generally denied the allegations in the various lawsuits, saying they were working to ease patients’ pain, stressing the complexity of causes behind the opioid crisis and pointing to other parts of the supply chain.

“Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated,” John Parker, a senior vice president of the Healthcare Distribution Alliance, a trade group, said in a statement last year. “Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”

Nationally, almost 400,000 people died from opioid overdoses between 1999 and 2017, according to the U.S. Centers for Disease Control and Prevention. That includes prescription medications and illicit drugs.

Public-health researchers have described three “waves” of the opioid epidemic in that time, starting with rising deaths due to prescription opioids like oxycodone. Around 2010, heroin deaths started to climb sharply. The past five or six years have seen a spike in deaths due to fentanyl, a synthetic opioid 50 to 100 times more powerful than morphine.

Heroin and synthetic opioids like fentanyl now cause more deaths than prescription painkillers, according to the CDC, though research suggests that many heroin users start with prescription opioids.

The lawsuits by Brattleboro and other municipalities seek to recover costs they say they have spent dealing with the opioid crisis, such as money spent on law enforcement and emergency medical services.

Paul Cuno-Booth can be reached at 352-1234, extension 1409, or Follow him on Twitter @PCunoBoothKS.