Doctor in Oklahoma Trial Says J&J Pushed Opioids Even After Abuse Became Known

Oklahoma’s star witness told a state judge that Johnson & Johnson pressed doctors to prescribe its painkillers even as the potentially fatal addictive threat posed by the drugs became clear more than a decade ago.

The judge, Thad Balkman, is presiding over the non-jury case and will make the final decision in the first trial where a state seeks to hold a drug maker responsible for contributing to the U.S. opioid epidemic. Oklahoma is seeking $13 billion in damages from J&J.

J&J “did everything it possibly could to get doctors to prescribe more and more opioids,” Dr. Andrew Kolodny, co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University in Waltham, Massachusetts, testified Tuesday during the third week of the trial.

In a novel attempt to hold a company accountable for the epidemic, Oklahoma Attorney General Mike Hunter claims J&J’s Janssen unit caused a health crisis under the public nuisance theory of law. That’s traditionally deployed to address real-estate disputes over chemical spills, noxious odors and loud noises.

The trial provides a preview of how similar claims may play out in October, when opioid drug makers and distributors go on trial in Cleveland. More than 1,900 such cases have been gathered there before a federal judge, who has been pushing for a settlement. Cities and counties contend they’ve spent billions in tax dollars on the societal fall-out from opioid-related overdoses and addictions.

An Oklahoma bench trial that started May 28 could take 2-3 months. A deal may be unlikely during trial unless the state makes concessions, given it would show weakness on the part of J&J.

Kolodny told Balkman that J&J profited even more from the crisis through its ownership of Australian poppy cultivator Tasmanian Alkaloids, which sold its active ingredient to other opioid makers including the company’s former co-defendants in the Oklahoma case, Purdue Pharma LP and Teva Pharmaceutical Industries Ltd. J&J has since sold the business. Purdue, the top marketer in the state, settled in March for $270 million. Teva agreed to pay $85 million days before the trial started on May 28.

J&J and its Janssen unit maintain they legally promoted and sold their fentanyl-based Duragesic pain patch and its Nucynta opioid painkiller and shouldn’t be held responsible for the misdeeds of other companies. Noting the other companies had settled when his client had not, defense attorney Larry Ottaway said at the trial’s outset, “When you are right, you fight.”

“The testimony of Dr. Kolodny was filled with rampant speculation and conclusions not derived from facts,” John Sparks, one of J&J’s lawyers, said in an email. He noted Kolodny acknowledged he had “no training or education in marketing.”

Kolodny told Balkman J&J and other opioid makers shouldn’t market their products as hard to abuse, since all have addictive profiles. Earlier in the trial, Oklahoma’s lawyers showed Balkman notes from Janssen’s sales reps indicating they’d told doctors the Duragesic patch had a low rate of abuse and downplayed its addiction risks.

They also used what the U.S. Food and Drug Administration concluded were unreliable studies to tout Duragesic’s benefits as a pain reliever and violated federal law by doing head-to-head comparisons of the pain patch’s advantages over Purdue’s Oxycontin painkiller, according to Hunter’s lawsuit.

Hunter claims J&J and Janssen duped doctors into prescribing the powerful medications for unapproved ailments, causing a wave of fatal overdoses and addictions. State officials are seeking damages to deal with current and future expenses tied to treatment and prevention of opioid addiction.

Kolodny has been active in the study and treatment of opioid addiction for more than a decade. His resume includes a stint with the New York City Health Department during the mayoral administration of Michael Bloomberg, founder and majority owner of Bloomberg News parent Bloomberg LP.

The case is State of Oklahoma v. Purdue Pharma LP, CJ-2017-816, Cleveland County, Oklahoma, District Court (Norman).