Lincoln, Sagadahoc and Waldo counties and multiple other Maine counties and municipalities are suing several manufacturers of opioid medications. The suit also names as defendants several pharmacies it accuses of selling them and three doctors it accuses of prescribing them.
According to court documents, those corporations and doctors engaged in deceptive business practices, making statements that opioid medications, such as Purdue Pharma’s OxyContin and oxycodon, were not as addictive as other painkillers, and enticed doctors and pharmacies to use the drugs for things other than their approved medical purposes, which include end-of-life care, temporary post-surgical treatment, and extreme pain owing to disease such as cancer.
Instead, according to the complaint, doctors were encouraged – for cash payments – to prescribe for less severe medical conditions such as migraine headaches and acute or chronic conditions such as toothache and back pain. This, the complaint alleged, led to dependency on the pharmaceuticals, eventually leading to the use of street drugs, which caused great societal harm to the counties and municipalities, such as increased cost to treat people with addiction disorder through both Lincoln Health and the Addiction Resource Center, increased cost of law enforcement, disruption of family life and cost to the state to place children in foster care, and increased incarceration at Two Bridges Regional Jail in Wiscasset.
In the complaint, Lincoln County Sheriff Todd Brackett also brought up his officers' administering of naloxone, with some overdoses requiring multiple doses. The Maine Attorney General’s Office pays for the doses, and as of this time, has used over 500 doses.
The plaintiffs seek $1 billion from each corporate defendant. According to court documents, the cost to address opioid issues in Maine was estimated at more than $93 million.
The complaint lists 22 drug manufacturers, six pharmacies and three doctors practicing in Maine as defendants. None could immediately be reached for comment.
The manufacturers named as defendants are Purdue Pharma LP, maker of OxyContin; Perdue Pharma Inc.; and the Perdue Frederick Company, all of Delaware and Connecticut; Teva Pharmaceuticals USA Inc. of Delaware and Pennsylvania; Cephalon Inc., of Delaware and Pennsylvania; Johnson and Johnson, of New Jersey; Jannsen Pharmaceuticals, Inc. of Pennsylvania and New Jersey; Ortho-McNeil-Jannsen Pharmaceuticals Inc., now known as Jannssen Pharmaceuticals Inc., of Pennsylvania and New Jersey; Jannsen Pharmaceutica, now known as Jannsen Pharmaceuticals, Inc., of Pennsylvania and New Jersey; Endo Pharmaceuticals Inc. of Delaware and Pennsylvania; Allergan PLC, formerly known as Actavis PLC, an Irish company in Dublin and New Jersey; Allergan Finance LLC, formerly known as Watson Pharmaceuticals, of Nevada and New Jersey; Watson Laboratories, Inc. of Nevada and New Jersey; Actavis LLC of Delaware and New Jersey; Actavis Pharma Inc., formerly known as Watson Pharma, Inc., of Delaware and New Jersey; Endo Health Solutions, Inc. of Delaware and Pennsylvania; Insys Therapeutics, Inc., of Delaware and Arizona; Mallinckrodt Enterprises, LLC, of Delaware and Missouri; McKesson Corporation of Delaware and California; Cardinal Health 110 LLC of Delaware and Ohio; and Amerisourcebergen Drug Corporation of Delaware and Pennsylvania.
The pharmacies named as defendants are CVS Pharmacy, Inc. of Delaware and Rhode Island; Walgreens Boots Alliance, AKA Walgreens Co. of Delaware and Illinois; Walmart Inc. of Delaware and Arkansas; Rite Aid Corporation of Delaware and Pennsylvania; Rite Aid of Maryland, of Maryland and Pennsylvania; and Rite Aid of Maine, of Maine and Pennsylvania.
The doctors named as defendants are Douglas J. Jorgensen, D.O., of Winthrop; Mark Cieniawski, M.D., of Portland; and Michael Bruehl, M.D., of Hermon.
According to the Maine State Board of Licensure, Cieniawski and Bruehl have been sanctioned within the last two years, both for complaints about how medication was prescribed. Cieniawski was fined $1,000, and the board will require Cieniawski to retain a consultant to monitor how he prescribes controlled substances while he completes more education about prescription practices. In Bruehl’s case, he is prohibited from prescribing controlled substances for more than seven days at a time, and is under probation for a year, and must obtain at least 30 hours of additional education in primary care and engage a Board-approved physician monitor who will review Bruehl’s prescribing, documentation, coordination of care and clinical knowledge.
Jorgensen’s case was different. According to court documents, Jorgensen admitted to a federal civil complaint that he violated the federal False Claims Act by submitting claims for evaluation and management services that were not eligible under Medicare. As part of the agreement, he reimbursed Medicare $124,110 to settle the lawsuit, which covered cases from 2011 through 2014. During that same period, Jorgensen had received pharmaceutical company payments given to doctors in Maine who prescribed particular opioids in the amount of $42,522. During the same period Jorgensen was treating people with pain owing to sport injuries at his main clinic in Manchester, he was also working as a drug addiction counselor at the Maine Recovery Center.
The plaintiffs, which include the counties of Androscoggin, Aroostook, Kennebec, Cumberland, York, Lincoln, Sagadahoc, Penobscot, Washington and Waldo, and most of Maine’s largest cities, including Portland, Lewiston, Waterville, Augusta, and Bangor, as well as many smaller towns, are represented by James Belleau and Adam Lee of Trafton, Matzen, Belleau and Frenette of Auburn.
Unlike an ordinary class action suit, each county and municipality will receive the benefits of the expenses they incur due to opioid use in their area, less legal fees. Twenty-seven states are also participating, and within states not currently participating, suits are being filed at the county, municipal, or tribal nation level. According to the Maine Attorney General’s Office, Maine is still considering its options. Attorney General Janet Mills, now governor-elect, has made the opioid crisis, which she has said has taken at least one life in Maine every day for the last several years, an important part of her platform during her run for governor.
The suit was filed Nov. 27. The defendants have 30 days to respond.