Arlington County has hit a setback in its fight against the opioid epidemic, as a high-stakes legal battle is mired in a squabble over where the case should be tried.

The county is currently suing dozens of businesses, such as CVS, Rite Aid, Walmart, McKesson Corporation and Express Scripts. In its lawsuit, the county says these manufacturers, distributors, and pharmacies were key players in the opioid problem.

The County Board is seeking “at least” $150 million plus other damages — punitive damages of $350,000 per defendant.

The suit argues that the epidemic has harmed the Arlington community in myriad ways, ranging from more babies exposed to the drugs and increased health care costs to impacts on everything from courts to schools’ treatment centers and employee benefit plans.

“‘Arlington County has been hit hard by the opioid epidemic,’ with increasing rates of neonatal abstinence syndrome and Hepatitis C since 2011,” notes a court document. “Moreover, the rate of overdose deaths in Arlington County has approximately tripled during the period of 1999 to 2016.”

The suit alleges that businesses caused harm by “misrepresenting the dangers of opioids, by failing in their obligations to report suspicious orders of opioid drugs, by working with their related pharmaceutical benefit manager entities to increase the usage of opioids, by flooding the country (and Arlington County)” with addictive drugs and more, lawyers for the county previously said in a court filing.

In court, the county has accused the defendants of gross negligence, unjust enrichment, conspiracy and more, saying prescription drug manufacturers, wholesalers, distributors, pharmacy benefit managers and pharmacies have created this epidemic.

Lawyers for the county said the addictive pain medications — sometimes prescribed for everyday conditions such as knee pain, headaches and dental pain — can act as a gateway drug to heroin and more.

As the suit has worked its way through the legal system since 2019, the county and the defendants have tangled over which court should hear the case, with the county pushing for state court, and at least one defendant arguing for federal court as the venue. Earlier this month the 4th U.S. Circuit Court of Appeals sent the case back to the lower federal court for further proceedings.

In appealing a U.S. district court decision about the venue selection, two defendants, Express Scripts Pharmacy Inc. and ESI Mail Pharmacy Service Inc., have argued they were administering a mail order pharmacy as part of the military’s TRICARE health program, thus making it a federal case, the appeals court said.

Those two affiliated defendants did not immediately respond to a request for comment.

The county said pharmacy benefit managers, including Express Scripts and others, are gatekeepers to the vast majority of opioid prescriptions in the U.S. and therefore influence prescription drug utilization, suggesting responsibility for monitoring and guarding against misconduct.

Photo by Joe Gratz/Flickr

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