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Will Cowlitz County join suit against opioid makers?

The Daily News - 4/1/2018

Several Washington counties, including some from Southwest Washington, have joined state Attorney General Bob Ferguson's lawsuit against opioid drug manufacturers.

Cowlitz County, which has the one of the state's highest opioid death rates, appears conflicted over whether to join the effort. But some clarity may emerge next week.

Ferguson filed a lawsuit in September against Oxycontin manufacturer Purdue Pharma, accusing the company of fueling Washington's opioid epidemic and running a massive deceptive marketing campaign against doctors and the public.

King, Clallam, Pierce, Thurston and Skagit counties have already filed suit against opioid manufacturers. The Lewis County commissioners are considering suing as well. Clark County joined the effort last week.

The situation is unclear in Cowlitz County. Commissioner Arne Mortensen strongly opposes the idea. Commissioner Dennis Weber supports it. Commissioner Joe Gardner is undecided. And another key decision maker in the matter, County Prosecutor Ryan Jurvakainen, says he, too, has yet to make up his mind.

Mortensen said the government should step out of the way between physicians and patients.

"It's not like these things haven't been known," Mortensen said of Oxycontin's addictive dangers. "People have known for years smoking is bad for you, that opiates are addictive and so forth. ... We're always shying away from people's responsibility."

According to drugabuse.gov, about one quarter of the patients prescribed opioids for chronic pain misuse them, with a further 10 percent developing an opioid use disorder. Suspected opioid overdoses rose from 15 to 20 per 10,000 emergency department visits in 2017 on the West Coast, according to the U.S. Centers for Disease Control and Prevention.

Mortensen referenced his own experience with Oxycontin after a back surgery two decades ago.

"It was a hell of a lot of pain," Mortensen said, "so I asked the physician 'How addictive is this?' and he said 'It's addictive, but you won't heal if you don't move, and you have to move despite the pain.' In 1998, it was known that Oxycontin was addictive. I can't imagine that anybody would claim that they didn't know."

According to the Washington Department of Health, Cowlitz County has the third highest rate of opioid related overdose deaths from 2012-16 in the state, with 13.6 deaths per 100,000 people. Commissioner Weber said a lawsuit is a way to hold drug manufacturers accountable and help compensate taxpayers for the costs of the many costs caused by addiction.

"To me, it's analogous to the tobacco lawsuit, where the tobacco companies were sued and forced into a settlement," Weber said. "... (there are) excessive amounts of jail time, substance abuse treatments, and all the problems dealing with opioid overdose. (It's) another example of where there have been errors made by certain interested (parties) for the sake of profits that have resulted in excessive costs to the taxpayers."

Weber said that physicians are "under the gun" from the federal government to improve pain management for their patients, and that some opioid companies are claiming their drugs are easy to manage despite the risks.

Weber urged the board in December to join him in endorsing a lawsuit. He said that the liability for covering opioid treatment should not fall entirely on taxpayers, and that a successful lawsuit could underwrite some of the costs of treating drug treatment.

"We've decided to borrow about $6 million to build a bigger morgue, in part because of the increase in opioid death," Weber said. "Our coroner doesn't have room to store bodies as they do investigations. So yeah, I think we should be at the table."

As a result of the December meeting, Weber asked the county prosecutor's office if it could join the lawsuits against the opioid makers. The answer was yes, but the commissioners have not taken up the matter since then, said Weber.

The final commissioner, Joe Gardner, said he's not yet ready to make a decision on the suit.

"I think I need to learn more about it," Gardner said. "I'm hesitant to say I'd join it at this point. ... We'd have to engage with the Cowlitz County prosecutor's office and get their take."

The ultimate decision likely rests with County Prosecutor Ryan Jurvakainen, who serves as the county's lawyer. Commissioners certainly can vote in an advisory capacity, but Jurvakainen could act on this own, Weber said.

"A lot of stuff has to be reviewed and discussed with commissioners and other people" before making a decision, Jurvakainen said Saturday.

"Ultimately, I guess it would be our discretion," he added, "but our job on the civil side is to be the county attorney. The commissioners are essentially the policy makers of the county."

Weber said he will bring the matter up again this week.

"The door is not closed. We could still take steps," Weber said.

Ferguson, the state attorney general, argues that Purdue Pharma gave specific physicians misleading information on drug abuse and addiction despite a 2007 court order prohibiting the company from doing so.

"Purdue ignored warning signs and their own studies while targeting high-prescribing doctors in Washington state," Ferguson wrote in January. "It's time they are held accountable for the devastation this epidemic has caused."