HUNTINGTON, W.Va. – Sarah Kelly recalls the fleeting moments when she reached out for help during a decadeslong opioid addiction, only to find out no residential treatment beds were available in an overloaded system in her corner of West Virginia.
In the hardest-hit county in the nation's worst-hit state for drug overdose deaths per capita, Kelly’s struggles with prescription pain pills cost her custody of her two children. Her younger sister died of a heart infection from intravenous drug use in 2017.
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Somehow, the Huntington resident wouldn't let her addiction win.
“I was so tired of living without them,” Kelly said. “I couldn’t live without them anymore.”
Six months have passed since closing arguments were held in the first lawsuit over the U.S. addiction epidemic to go to trial. It blames three pharmaceutical companies for their role in the opioid crisis in the Huntington area. For Kelly and others who know the desperation that comes with addiction, the time it's taken to render a verdict seems out of step with the urgency they feel.
Kelly eventually found treatment and went to court to get her kids back. She's been in recovery since October 2019. But that nightmare of being unable to locate a bed right away comes rushing back as a decision looms in the lawsuit.
Cabell County and the city of Huntington sued AmerisourceBergen Drug Co., Cardinal Health Inc. and McKesson Corp. A federal judge must rule whether the companies created a public nuisance in distributing 81 million prescription pain pills over eight years — and whether they ignored signs that the Ohio River community was being ravaged by addiction.
The plaintiffs are seeking more than $2.5 billion. The money would go toward prevention, treatment and education.
Kelly, 38, said the help can't come fast enough.
“There’s people dying every single day,” Kelly said. “So many of us are lucky to be alive and have found treatment. There’s a lot of people that could really benefit from this. There's a lot of programs that could benefit from this and save lives.”
From 2015 to 2020, Cabell County had 8,252 people — about 10% of its population — suffering from opioid use disorder, plaintiffs attorney Paul T. Farrell Jr. said in his closing arguments, citing expert testimony. The county has 106 Medicaid-approved beds for residential treatment of those patients, according to the state Department of Health and Human Resources.
Closing arguments were held in late July after the nearly three-month bench trial in Charleston. U.S. District Judge David Faber has yet to indicate when he might rule.
“It is worrisome that it is taking a long time, even though we know these things take time,” said Kim Miller, an addiction counselor at Prestera Center, a Huntington treatment facility. “The longer it takes, the more questions arise, and the less likely it feels to get a satisfying verdict.”
For many people who have abused prescription pain pills, any money from the trial “is going to come too late,” Miller said.
In Cabell County last year, there were nearly 900 emergency medical responses for suspected overdoses. In 3% of the cases, the patient was pronounced dead at the scene. An estimated 1,400 emergency room visits in the county were related to overdoses, according to the DHHR.
Attorneys familiar with the trial said they're not alarmed by the months without a verdict.
“A lot of people have been waiting for a long time, and maybe people underestimate the complexity of the case and the difficulty of coming to a resolution," said Carl Tobias, a University of Richmond law professor. “I think Judge Faber is just taking the time that is needed to get it right.”
West Virginia University law professor Patrick McGinley, representing the newspaper group HD Media, was instrumental in forcing the Drug Enforcement Administration to release a database of distributor pain pill shipments across the United States, including more than 1 billion to West Virginia from 2006 to 2014. The Charleston Gazette-Mail won a 2017 Pulitzer Prize for reporting on the state’s opioid crisis.
McGinley, who teaches a seminar in prescription opioid litigation, said the trial in Faber's courtroom “would produce thousands if not tens of thousands of pages of transcripts of testimony, hundreds if not thousands of exhibits," and then Faber has to research the law.
Public nuisance claims drive some 3,000 lawsuits brought by state and local governments against drugmakers, distribution companies and pharmacies. Faber can peek at cases in other states; since the end of closing arguments, other opioid trials have come and gone.
In northern Ohio, a federal jury in November ruled that CVS, Walgreens and Walmart pharmacies recklessly distributed massive amounts of pain pills in two counties. A judge will decide by spring how much the pharmacies must pay in damages.
A jury on New York’s Long Island found in late December that drugmaker Teva Pharmaceuticals contributed to the opioid crisis there. A separate trial will determine what Teva will have to pay.
Drug companies prevailed in lawsuits decided in November in northern California and in Oklahoma.
A judge rejected OxyContin maker Purdue Pharma’s sweeping settlement of thousands of lawsuits in December. Another judge refused to allow litigation to move ahead against members of the Sackler family who own the company but also ordered negotiations for a reworked settlement.
The opioid crisis has been linked to more than 500,000 deaths in the U.S. since 2000, counting overdoses of both prescription opioids and illicit ones such as heroin and fentanyl.
McGinley said that although Cabell County and Huntington need resources now to deal with the opioid problem, the case likely won’t end with Faber’s decision.
“This is the legal process; we have to ensure fairness and compliance with the rule of law,” McGinley said. “There’s a saying: The wheels of justice grind exceedingly slow. That’s certainly what it seems in a case like this.”