Quarter of patients addicted after opioid pain prescription, doctor testifies

One in four patients will become addicted after being prescribed opioids for pain, a leading doctor testified Tuesday in a $50 billion bench trial in Orange County in which the state claims Purdue Pharma and other drugmakers falsely advertised that "addiction to opioids is rare."

Dr. Anna Lembke of Stanford School of Medicine, who was recently featured in the HBO documentary "The Crime of the Century," testified via Zoom as a key witness for the state that opioid manufacturers made false and misleading statements to doctors over the last 20 years.

Messages that "no dose of opioids for the treatment of pain is too high," "physiologic opioid dependence is benign and easily reversible," and "addiction to opioids prescribed for treatment of pain is rare," were all false and commonly used among sales representatives who marketed opioids to physicians, Lembke testified during the state's direct examination.

One in four patients becoming addicted "by any measure, is not rare," she said.

The outcome of the monumental bench trial, being tried remotely before Superior Court Judge Peter Wilson, could provide a road map for thousands of settlements in lawsuits filed nationwide by states and municipalities that claim Purdue and other opioid producers fueled an opioid crisis by deceptively marketing their drugs and downplaying the risk of addiction.

The four main defendant companies are Teva Pharmaceuticals, Endo Pharmaceuticals Inc., Allergan PLC, and Johnson & Johnson subsidiary Janssen Pharmaceuticals Inc. Purdue, also a named defendant, is sitting out the civil trial pending its bankruptcy proceeding in New York. During opening arguments last month, defense attorneys seemed intent on casting doubts about whether an opioid crisis in the state ever existed. One attorney told the judge he should compare the state's 17,000 opioid prescription related deaths in 2018 to the almost 60,000 cancer deaths that occurred that same year.

However, representing one of the four plaintiff municipalities, Oakland Deputy City Attorney Malia McPherson asked Oakland Police Officer Julian Bordona, who also testified Tuesday, if he personally observed a change in his community in recent years in regard to opioid use.

"There's been an explosion, if you will, in the amount of paraphernalia found in the community," Bordona replied. "I have seen it affecting almost all areas I encounter."

Along with the Oakland city attorney's office, arguing for the people of California are the Santa Clara County counsel's office, Orange County district attorney's office and the Los Angeles County counsel's office.

The people's case, which at times has been slowed by discovery disputes and is nearing a month in length, is expected to end early next week, attorneys indicated Tuesday.

As of now, the four drug companies have 45 potential witnesses on their list to call in the coming weeks, according to Rhode Island plaintiffs' attorney Fidelma L. Fitzpatrick of Motely Rice LLC, who represents the state.

However the defense is expected to trim that list when the people conclude their case in chief, the judge said.

In addition to civil penalties, the people seek $50 billion in funds to abate the opioid crisis in the plaintiff counties and city, according to attorneys involved in the suit. People v. Purdue Pharma et al., 14-00725287 (Orange Super. Ct., led May 21, 2014).