Update on this topic:Indianapolis files federal lawsuit against opioid companies

Indianapolis Mayor Joe Hogsett unveiled a provocative new strategy Thursday to fight a burgeoning opioid epidemic: suing the pharmaceutical companies and drug distributors.

Standing on the 25th floor of the Downtown City-County Building, with a sweeping view of Indianapolis below, Hogsett shared a grim reality about how painkillers such as OxyContin and Oxycodone have led many in the city down a path of addiction and into the throes of heroin.

The result, according to multiple people interviewed by IndyStar over several months, is a crisis that shows no sign of ending. Emergency rooms are full. Jails are overcrowded. And more people are dying of drug overdoses than in car crashes.

“Opioids are killing Americans. Opioids are killing Hoosiers. Opioids are killing our neighbors right here throughout the city of Indianapolis," Hogsett said.

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Hogsett pointed the blame at opioid makers and distributors, saying corporate executives chose to collect profits while ignoring their responsibility to be gatekeepers of the "highly addictive and potentially lethal drugs."

There were 345 drug overdose deaths in Marion County last year, according to a city news release citing Indiana University research. State numbers, which differed from the city's, saw drug deaths spike to 1,498 last year, according to the state's new Next Level Recovery website

An attorney representing the city named three opioid makers — Purdue Pharma, Endo and Teva — and three distributors — Cardinal Health, McKesson Corporation and AmerisourceBergen — as likely defendants, though there could be others.

The companies released statements to IndyStar regarding the allegations.

“We are deeply troubled by the opioid crisis and we are dedicated to being part of the solution," a Purdue Pharma statement read, in part. "We vigorously deny these allegations and look forward to the opportunity to present our defense.”

"At Endo, our top priorities include patient safety and ensuring that patients with chronic pain have access to safe and effective therapeutic options," an Endo statement read. "We share in the FDA’s goal of appropriately supporting the needs of patients with chronic pain while preventing misuse and diversion of opioid products."

"Teva is committed to the appropriate use of opioid medicines, and we recognize the critical public health issues impacting communities across the U.S. as a result of illegal drug use as well as the misuse and abuse of opioids that are available legally by prescription," a Teva statement read. "Teva offers extensive resources for prescribers, patients and pharmacists regarding the responsible pain management and prevention of prescription drug abuse."

"As distributors, we understand the tragic impact the opioid epidemic has on communities across the country. We are deeply engaged in the issue and are taking our own steps to be part of the solution — but we aren’t willing to be scapegoats," said John Parker, senior vice president of Healthcare Distribution Alliance, which represents the three distribution companies named by the city. "We don’t make medicines, market medicines, prescribe medicines or dispense them to consumers. Given our role, the idea that distributors are solely responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and how it is regulated."

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Indianapolis is not the first city to pursue legal action against opioid companies.

Several Tennessee counties filed a suit in June against Purdoe Pharma, Endo and Mallinckrodt Pharmaceuticals.

Louisville, Ky., filed a suit against the three distributors in August, saying the companies failed to monitor suspicious activity and report it to the U.S. Drug Enforcement Administration.

This past week, Seattle filed a suit against several companies. Washington state filed a suit too, as has Ohio and Mississippi.

In June, Indiana Attorney General Curtis Hill said he would join other attorneys general to investigate the role of opioid makers in the epidemic. On Thursday evening, Hill released a statement saying his office is still determining whether Indiana would pursue any legal action. His office has not been consulted by the city regarding Indianapolis' potential lawsuit, according to the statement.

More than 75 lawsuits have been filed nationwide, said Levin, the attorney representing Indianapolis.

The cities and states are likely following in the footsteps of those who pursued legal action against tobacco companies in the past, said Jon Caulkins, professor of Operations Research and Public Policy at Carnegie Mellon University’s Heinz College.

"I wouldn't be surprised if they weren't very cognizant of that precedent and trying to do the same thing," Caulkins said.

After a flurry of lawsuits, tobbaco companies reached a settlement that changed their marketing, products and pricing, Caulkins said — several major changes that otherwise wouldn't have happened.

The companies took a massive financial hit, Caulkins said, but it was preferable to several decades of lawsuits with numerous plaintiffs, including states’ attorney generals.

Successful lawsuits could help Indianapolis financially, Caulkins said, but also could force opioid companies to confront the existing crisis.

"The ultimate goal is a belief that the country would be a better place if we could get another set of industry practices,” Caulkins said.

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On Thursday, Hogsett said Indianapolis has been forced to come up with new ways of confronting the opioid crisis, including the creation of Mobile Crisis Assistance Teams.

The teams — staffed with one police officer, one paramedic and one licensed clinician — are responding to crisis calls on the east side. They try to help those struggling with addiction rather than throw them into a jail cell.

Indianapolis Metropolitan Police Sgt. Catherine Cummings, who helped launch the teams, noted the team is trying help people navigate a problem "that's bigger than they are."

"Indianapolis is being very innovative in that approach," Cummings said. "We're not using the traditional public safety response."

But even as Cummings and other city officials seek progress in new programs, Hogsett said it's not enough.

“We have fought back as best we can," Hogsett said, "only to find this epidemic untenable.”

Irwin Levin, a managing partner of Cohen & Malad, LLP, will represent the city. The law firm will be paid one-third of any winnings, Levin said, and the city won't pay hourly or assume any upfront costs.

A lawsuit has not been filed, but is expected in the "coming weeks," he said.

He did not specify how much damages the city is seeking.

The Associated Press and USA TODAY Network contributed to this story.

Call IndyStar reporter Ryan Martin at (317) 444-6294. Follow him on Facebook and on Twitter: @ryanmartin.

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IndyStar’s “State of Addiction: Confronting Indiana's Opioid Crisis” series is made possible through the support of the Richard M. Fairbanks Foundation, a nonprofit foundation working to advance the vitality of Indianapolis and the well-being of its people.