White pills on a black background

Opioid-Crisis Lawsuit Heads for Rare Trial in West Virginia

The city of Huntington, W.Va., and surrounding Cabell County are seeking more than $1 billion from three drug distributors: McKesson, AmerisourceBergen and Cardinal Health

This article was originally published in the Wall Street Journal.

In the Ohio River city of Huntington, W.Va., people like Amanda Coleman have fought the opioid epidemic for years in a battle that seems never-ending. She traces many local problems—homelessness, mental illness, an HIV outbreak—back to opioids.

“It’s implicated in everything that we do,” said Ms. Coleman, the executive director of a homeless-services organization in Huntington, a city of 45,000 near the intersecting borders of West Virginia, Ohio and Kentucky.

Now, lawyers for Huntington and the surrounding Cabell County will begin arguing Monday in a federal courthouse that the nation’s three largest drug distributors— McKesson Corp. , AmerisourceBergen Corp. and Cardinal Health Inc. —should help bear their community’s costs of addressing widespread opioid addiction. The trial will be the first courtroom test of a legal theory put forward in more than 3,000 other lawsuits: That the wholesalers created a “public nuisance” by letting prescription drugs flow into the community unchecked, and that now they need to pay to abate the problems it created.

Huntington and Cabell have pressed for a trial, even after the state’s attorney general settled with McKesson, AmerisourceBergen and Cardinal for $73 million between 2017 and 2019. And the trial is moving ahead despite the three companies, and drugmaker Johnson & Johnsonoffering $26 billion to settle all of the opioid litigation across the country.

The reason for the gamble: Only about 1% of that money would go to West Virginia, and that isn’t nearly enough, plaintiffs’ lawyers say. If victorious in a bench trial in Charleston, W.Va., before U.S. District Judge David Faber, Huntington and Cabell are seeking more than $1 billion, to be used locally to bolster efforts like Ms. Coleman’s.

The trial will aim to “hold these companies accountable, and help restore these communities,” co-lead plaintiffs’ lawyers Paul Farrell and Anne McGinness Kearse said.

Huntington has been a hard-hit city in a state that has suffered some of the harshest effects in the nation from the opioid epidemic. West Virginia’s per-capita death rate from opioid overdoses was the highest in the country in 2018, according to federal data. Around 5% of West Virginia babies are born to mothers using opioids, the cause of lifelong health problems, compared with less than 1% nationally.

“Painkillers became so easy to get, it almost became cultural,” said Tim Craft, the head of a ministry in West Virginia that helps people overcome addiction. Mr. Craft, himself a recovering addict who lost a sister to an overdose, began taking prescription opioids as a teenager to deal with migraines and later switched to heroin.

McKesson, AmerisourceBergen and Cardinal Health aren’t household names, but they are among the highest-grossing companies in America and control the flow of healthcare products ranging from surgical gloves to Covid-19 vaccines.

In Huntington’s lawsuit and hundreds of others, states and municipalities allege the distributors allowed pills to flood into pharmacies largely unchecked, and that the companies should have taken greater steps to ensure prescription drugs weren’t being diverted for improper uses.

The companies counter that there are far too many steps between them and the actual use of opioids to be held accountable for what they acknowledge is a public-health crisis. In court papers, the companies said a doctor first had to prescribe a drug, dispensed by a pharmacy to someone legally entitled to it, which was then given to someone to abuse—a chain of events the distributors say doesn’t involve them.

AmerisourceBergen said it followed the quotas set by the Drug Enforcement Administration for opioid painkillers, reported all controlled-substance sales and suspicious orders to the DEA and verified all pharmacy licenses. McKesson and Cardinal declined to comment ahead of the trial.

The companies also plan to argue West Virginia has been heavily affected by illegal opioids, like heroin and synthetic fentanyl, that have nothing to do with their business.

The thousands of opioid lawsuits filed nationwide argue that illegal opioid use often starts with addiction to pain pills, which pharmaceutical companies fostered through aggressive marketing of their drugs to doctors.

The lawsuits drove the biggest target of the claims, OxyContin maker Purdue Pharma LP, into bankruptcy in 2019. The company is now negotiating a multibillion-dollar deal with states and other creditors.

Deal talks over the $26 billion offer by McKesson, Cardinal, Amerisource and Johnson & Johnson have dragged on, however, since late 2019, as states fight among themselves over their share of the settlement and the companies try to get assurances that the money will actually resolve the majority of the claims. Another opioid trial is under way in California, being held virtually and in a case involving four drugmakers, not distributors.

West Virginia resident Sandra Blankenship is hoping to get a payout in Purdue Pharma’s bankruptcy. She adopted a baby girl in 2012 who had neonatal abstinence syndrome because of a mother using opioids.

An intensive-care-unit nurse at the time, Ms. Blankenship said she thought she could handle any challenges the condition brought.

Looking back, she said, “nothing could have prepared me for this.” For three years, her daughter barely slept and struggled to swallow food. She now has trouble focusing and learning basic math concepts.

Ms. Blankenship said most of her friends in southern West Virginia are raising their grandchildren because their children can’t care for them.

“It’s drugs,” she said. “It’s all drugs.”