Loudoun could be the latest of several Virginia jurisdictions to take opioid manufacturers and distributors to court, following direction by the Board of Supervisors to seek outside counsel to measure costs to the county government.
If the county decides to pursue a lawsuit, it could be far-reaching.
“You’re really looking at the whole supply chain,” said Board of Supervisor Vice Chairman Ralph M. Buona (R-Ashburn). “You’re looking at manufacturers, you’re looking at distributors, and you’re looking at pharmacies. You’re looking at the whole supply chain, not just the drug companies themselves.”
The county would also have the option of joining one of the ongoing lawsuits in federal and state courts or launch its own suit.
The decision follows Virginia Attorney General Mark Herring’s lawsuit against Purdue Pharma filed in June, arguing the company’s practices violate the Virginia Consumer Protection Act and accusing the company of “a decades-long, complex, large-scale campaign of misrepresentations and deception.” Purdue is the manufacturer of OxyContin, among other drugs.
“For decades, Purdue Pharma has amassed a fortune and built an empire on suffering and lies about the dangers of its drugs and its central role in creating and profiting from the deadliest drug epidemic in American history,” Herring said in a statement announcing the lawsuit. He said at the heart of the problem were the company’s lies that its opioids were safe, had little risk of addiction, and were more effective than other painkillers.
Herring’s lawsuit also argues Purdue promoted a made-up condition called “pseudoaddiction” in which signs of addiction just meant patents needed higher doses, and lied about the risks of higher doses. Herring said more than a third of the people who have sought substance abuse treatment from a Community Services Board were seeking help with opioid abuse, and from 2007 to 2017, 7,890 Virginians died of an opioid overdose, including 4,929 from prescription drugs.
Several other state attorneys general have also sued Purdue Pharma.
“We’ve been following this for several months, probably almost up to a year now, watching what other localities are doing, what the Commonwealth is doing,” said Loudoun County Attorney Leo Rogers. He said a consortium of law firms specializing in this kind of work would assess the county’s damages for free, and if the board decides to move ahead with a lawsuit, the county government would retain a law firm for a percentage of whatever money the county wins. Rogers said about 25 localities have already done this.
The project poses an expansive question for the county: how to measure up all the costs of the opioid crisis to the county’s many departments.
“It’s going to come out of public safety obviously,” said County Attorney Leo Rogers. “And then it’s going to come out of social services, mental health, the health department.”
Assistant County Administrator Valmarie Turner said her staff have already begun interviewing with the law firm of Sanford Heisler Sharp to begin that work. She oversees the county’s departments of Community Corrections; Family Services; Health Services; Mental Health, Substance Abuse and Developmental Services; and the Juvenile Court Services Unit.
“It’s definitely impacting Loudoun County,” Turner said. “Loudoun County did not escape it at all, but in terms of being able to quantify it and put a number to it, we don’t have that yet, so that’s something that we hope to get.”
Her departments have launched a variety of specialized programs and internal training to cope with the impact of opioid addiction, including Revive. That free, one-hour clinic is open to the public and teaches signs of an opioid overdose and how to respond with naloxone, an emergency treatment to reverse opioid overdoses. People who complete that training can also receive a free naloxone nasal spray. It is offered by the Department of Mental Health, Substance Abuse and Developmental Services.
The Loudoun County Sheriff’s Office has also equipped all of its patrol deputies with naloxone. The department is also part of the Heroin Operations Team, a partnership among local, state and federal law enforcement; Loudoun County Public Schools; Loudoun County Department of Mental Health, Substance Abuse, and Developmental Services; and other entities within the Community Services Board.
The sheriff’s office marked slight decrease in the number of overdoses to which it responded from 2016 to 2017. It reported 19 fatal overdoses and 69 fatal overdoses in 2016 for a total of 88, and 17 fatal and 63 nonfatal in 2017 for 80 overdoses. That makes Loudoun the only jurisdiction in the Baltimore-Washington region to see a decrease in overdoses and overdose-related deaths, some of which saw large increases.
This year, the department has seen an increase in overall opioid and heroin related fatalities compared to this same time last year.
Fire-Rescue System Operational Medical Director Dr. John Morgan said while the opioid crisis hasn’t hit Loudoun as hard as some other areas—such as areas immediately west of the county—it has nonetheless impacted firefighters, paramedics, and EMTs. For fire and rescue staff, he said, the crisis has meant “more training, more outreach, more equipment, and some increase in volume but certainly not overwhelming on us as an agency.”
While the county’s fire and rescue crews have carried injected version of naloxone for more than 30 years, they have also begun carrying the nasal spray. And while previously only highly trained paramedics were trained in administering naloxone, now EMTs and firefighters—who have lower medical certifications—are also trained to recognize opioid overdoses and administer naloxone.
Morgan said the opioid crisis has also brought a “heightened sense of awareness and concern” for medical personnel who administer opioid painkillers on the job.
“It’s something that, medically, we’ve used for many, many years and very safely, so that’s always a bit of challenge,” Morgan said. “With what’s going on, we still have a legitimate need to treat acute pain.”
He, too, has already been contacted to take part in the county’s assessment, as it considers whether to pursue a lawsuit.
Sanford Heisler Sharp attorney Andrew Miller said that his firm is assessing the direct cost of the epidemic through a “comprehensive analysis that takes into account the complexity and multi-faceted nature of the harms inflicted by the opioid epidemic.”
“The opioid epidemic has had a profound impact on spending in localities across the country and we suspect that Loudoun County is no exception,” Sharp wrote. “Some of the direct costs that we will consider include correctional services, policing services, court administration, social services, foster care services, emergency response services, educational services, mental health and addiction treatment services, and certain publicly-funded health services.”
“The vast majority of opioid addictions in the world—and I’m talking 90-plus percent—are in the U.S., and the reason for that is we are promoting opioids as pain management,” Rogers said. “It is a crisis of the making of manufacturers, distributors, and benefits managers.”
More information and registration for Revive training is at loudoun.gov/revive.