Legal offensive against opioids worth trying

Nineteen years ago, the attorneys general of 46 states inked an agreement with the four largest U.S. tobacco companies. The states agreed to drop the Medicaid lawsuits they had filed to recover smoking-related health care costs; the companies agreed to change their marketing and make payments to the states - a minimum of $206 billion over the first 25 years. It was called the Tobacco Master Settlement.

Is a similar day of reckoning ahead for the pharmaceutical companies that mass-marketed prescription painkillers, putting down the foundation for today's explosive growth in illegal opioid use? No one really knows. The pharmaceutical companies may be tougher legal targets than the tobacco firms.

But County Executive Steve Schuh, facing a public health crisis that led to more than 150 overdose deaths in Anne Arundel last year, has signed up the county for the legal offensive. And he is right to have done so.

In September, Schuh announced that the law firm of Motley Rice had been hired to investigate and sue opioid manufacturers, distributors and local doctors accused of converting their practices into "pill mills." On Wednesday, with the filing of papers in Circuit Court, Anne Arundel became the first county in Maryland to take not just individual doctors but the pharmaceutical industry to court. Similar legal efforts have been popping up around the country; Motley Rice's website says it is representing four states and 12 municipalities or counties in similar lawsuits.

Anne Arundel's lawsuit includes individuals already targeted by the state attorney general on allegations of improper prescribing. But there are also some of the biggest pharmaceutical companies in the country, including Purdue Pharma, maker of OxyContin, and Endo Pharmaceuticals, manufacturer of Percocet. The lawsuit contends the companies misled doctors and medical practices about the drugs' effects, telling "doctors that patients who did appear addicted were not; they were 'pseudoaddicted' and needed more opioids."

In September, acting county Health Officer Fran Phillips cited a New England Journal of Medicine study reporting that prescription drugs started the addictions of 75 percent to 80 percent of those hooked on opioids in the 2000s. Once law enforcement noticed the booming market in illegal prescription painkillers and cracked down, many addicts switched to heroin, which was cheap and available.

But, as Alana Semeuls noted in the Atlantic last year, lawsuits by individuals against drug companies rarely succeed, because the courts make a distinction between health damage from using a legal product as it was marketed to be used - for instance, smoking cigarettes - and obtaining pills on the black market and using more than was prescribed. Even in lawsuits brought by governments, the companies may be able to shunt liability to doctors or addicts.

But that's ultimately for the courts to determine, and it obviously doesn't hurt to go after local doctors and practices if can be proved they have made the situation worse by consistently and recklessly overprescribing. By taking the lead on this in Maryland, Schuh is living up to his promise to be aggressive and imaginative in combating the flood of opioids.