State official: Marketing worsened Oklahoma's opioid crisis
Daily Oklahoman - 6/26/2019
Jun. 26--NORMAN -- Johnson and Johnson "unleashed a series of bombs on the United States of America" that caused the opioid epidemic, Oklahoma's mental health commissioner testified Tuesday.
"Those bombs hit squarely, squarely in the middle of our country in Oklahoma," said Terri White, commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services.
Oklahoma didn't see it coming, but realized it had sustained a direct hit in 2011 when the state Health Department reported that for the first time in state history drug overdoses had surpassed car accidents as the No. 1 cause of accidental deaths, White said.
"We knew we had a crisis," White said. "This was all hands on deck."
White testified about steps the state has taken to reverse the opioid crisis Tuesday during week five of a trial in Cleveland County District Court. Johnson & Johnson has been accused of creating a public nuisance that helped cause the opioid epidemic through false and misleading marketing efforts that downplayed the addictive and overdose risks of opioids, while overstating their therapeutic benefits.
White said as soon as the state realized it had a problem, officials began forming work groups to try to solve it.
Very quickly, state substance abuse officials realized they had an opioid oversupply problem, White said.
To combat that problem, officials took numerous actions, including developing opioid prescription guidelines, pushing for legislation to limit the number of pills in an opioid prescription and pushing to limit the number of hydrocodone pill refills, she said.
Through the state's opioid litigation, White said she has been able to view previously confidential Johnson & Johnson documents that show at same time state officials were fighting to reduce the opioid supply in the state, Johnson & Johnson was "unleashing their sales force" on Oklahoma doctors in an effort to convince them that opioids were not as addictive as traditionally believed.
That marketing effort was extremely effective, White said, pointing to a report that 6,137 Oklahomans died from opioid-related drug overdoses between 2000 and 2017.
White said she was offended by Johnson & Johnson's contentions that it has no financial responsibility to help Oklahoma abate the opioid crisis because in addition to marketing its own opioids, Johnson & Johnson provided the active ingredient for many other opioid manufacturers that sold products in the state.
"That's not right. That's not just, and that's insulting," White testified.
White is one of the primary architects of Oklahoma's abatement plan that the state is asking District Judge Thad Balkman to adopt. The 30-year plan calls for Johnson & Johnson to pay more than $17.5 billion to abate the opioid crisis.
During cross-examination, Johnson & Johnson attorney Stephen Brody questioned White about a number of situations where Oklahoma agencies had opportunities to curb the over-prescription of opioids before the problem peaked in Oklahoma from about 2009 to 2013.
Brody pointed to agenda packets for several Oklahoma Drug Utilization Review Board meetings that took place from 2001 through 2004. Those packets showed the board was asked to consider recommending that opioid prescribing be restricted in various ways, but chose not to do so.
In one instance, Annette Prince, an assistant attorney general during former Attorney General Drew Edmondson's administration, spoke against requiring physicians to require prior authorization for opioid prescriptions beyond 60 tablets for 30 days. Prince warned board members that the proposal could have a "chilling effect on physicians' treatment of pain."
When White was questioned about that by Brody, she said it showed how effective Johnson & Johnson's marketing campaign was at convincing Oklahomans that untreated pain was a huge problem.
"Oklahomans were duped by that marketing campaign," White said.
Brody also questioned White about an opioid pill mill that was allowed to keep operating for years in Roland even though the OklahomaBoard of Medical Licensure and Supervision conducted an undercover operation in 2007 and found Dr. Ronald Myers was not following proper prescribing practices.
Years later, that same pill mill was linked to as many as 8 to10 deaths, a subsequent investigative report indicated.
Myers was charged in 2016 with racketeering and unlawful distribution of a controlled and dangerous substance. He surrendered his medical license in 2015 and died last year.
Earlier in the trial, there was testimony that a Johnson & Johnson sales representative targeted Dr. Myers for marketing efforts in 2010 that were designed to increase opioid prescriptions.
Brody asked White if any state agency ever notified Johnson & Johnson or Janssen Pharmaceuticals Inc. about the results of its investigations into Dr. Myers. White said she didn't know.
Testimony is scheduled to resume 8:30 a.m. Wednesday.
(c)2019 The Oklahoman
Visit The Oklahoman at www.newsok.com
Distributed by Tribune Content Agency, LLC.