Judge rules opioid case should continue moving forward
NORMAN — Millions of opioid tablets have been stolen or improperly dispensed from Oklahoma pharmacies, a compliance officer for the Oklahoma State Board of Pharmacy testified Monday.
Gulf Coast Pharmaceuticals Inc., a Mississippi-based pharmaceutical supply company, had its license revoked and was fined $22,500 by the state pharmacy board in 2010 after an investigation revealed it had improperly disbursed 6,721,000 opioid tablets through two pharmacies located on Indian land, documents revealed.
Compliance officer Gary Michael LaRue testified by video deposition that the prescriptions were all filled without a valid physician-patient relationship and without the involvement of a pharmacist licensed through the state.
"They were open on tribal land and nobody felt like they had jurisdiction," LaRue said.
The prescriptions were filled through Elk River Pharmacy ostensibly licensed through the Seneca Cayuga Tribe and White Eagle Rx licensed through the Ponca Tribe, he said.
LaRue testified about numerous other instances where opioids have been stolen and diverted by Oklahoma pharmacists or pharmacist technicians.
For example, he said 399,500 hydrocodone tables were diverted by a pharmacy technician at Hillcrest Medical Center who admitted taking the tablets and providing them to her daughter's boyfriend, who was in a gang. The pharmacist in charge notified the board after the employee was terminated and the pharmacy was fined $129,000, LaRue said.
In another case, a pharmacy technician admitted taking 217,000 doses of oxycontin and hydrocodone from Sooner Pharmacy of Tishomingo and using them to pay off a daughter's debt to a drug dealer. The board suspended the pharmacy's license for five years and imposed a $40,000 fine, LaRue said.
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- Video: Oklahoma Opioid Trial: Judge rejects motion, trial continues
Johnson & Johnson attorneys introduced LaRue's video into evidence Monday, apparently to show that the state's failure to control thefts from and improper dispensing by pharmacies in the state has contributed to the state's opioid epidemic.
Earlier Monday, Cleveland County District Judge Thad Balkman ruled that attorneys for the state had presented sufficient evidence to warrant moving forward with their case against opioid manufacturer Johnson & Johnson and its subsidiaries.
Judge Balkman rejected a request by the drug maker to end the trial early by dismissing the case.
"I've determined that there is sufficient evidence of the state's nuisance claim against the Janssen defendants to deny the defendant's motion for judgment," Balkman said. "The motion is denied and the trial will proceed."
Janssen Pharmaceuticals Inc. is one of Johnson & Johnson's many subsidiaries.
In making his ruling, Balkman said he was taking into consideration not only the approximately two hours of legal arguments presented Monday morning, but also lengthy legal briefs that had been filed and testimony from throughout the trial, which has been going on for more than a month.
The state has accused Johnson & Johnson of creating a public health crisis that has led to thousands of overdose death through false and deceptive marketing efforts that overstated the benefits of opioid painkillers while understating their risks.
In requesting dismissal of the case, Johnson & Johnson attorney Stephen Brody argued that the drug maker's actions did not fit the legal definition of a public nuisance and that the company's First Amendment right to free speech protected the marketing claims it made about use of opioids to treat chronic pain.
Brad Beckworth, one of the attorneys for the state, was dismissive of Johnson & Johnson's attempt to get the judge to terminate the trial early.
"It's a PR stunt," Beckworth said. "That's all it is."
“In every turn of this case, Johnson & Johnson has attempted to keep the judge and the public from seeing the truth," Attorney General Mike Hunter said after the judge issued his ruling. "Luckily, Judge Balkman has seen through all of these desperate motions that have attempted to remove, halt or delay the trial and justice for the thousands of deaths due to the epidemic.”
After the judge's ruling, Johnson & Johnson attorneys playing a video deposition of Dr. Charles Argoff, an Albany, N.Y., pain management doctor who has been paid tens of thousands of dollars by an assortment of drug companies to serve on advisory boards, represent them in speakers' bureaus and to speak to doctors at continuing education events.
Argoff said he doesn't believe opioid manufacturers were responsible for the opioid epidemic, which has resulted in nearly 7,000 opioid-related overdose deaths in Oklahoma, alone.
"I don't think they bear any direct responsibility," Argoff said. "I think that there is no clear culpability on the part of the pharmaceutical industry."
At one point in the video, Argoff was questioned about a quote that was attributed to him in a drug company news release. The quote was actually written by a drug company representative and then sent to Argoff for approval, according to email acquired by Oklahoma's attorneys.
"I agreed with the comments attributed to me," Argoff said.
Also testifying Monday was Dr. Jeff Halford, a Broken Arrow pain management doctor.
Halford testified that the ability to prescribe opioids is an important part of his medical practice and he considers them medically necessary to helping many patients improve functionality.
Halford downplayed the influence of drug company sales representatives, comparing them to car salesmen and saying he takes everything they say with a "grain of salt."
"I'm very skeptical of anything any sales person ever in the history of the universe says," Halford said. "I'm going to do my own research."
Halford testified he gets most of his patients by referral and estimated 95% or more of them are already on opioids when they first come to his office.
He estimated that 60% to 70% of the time he tries to lower the strength of the opioids his new patients are taking or switch them to another type of lower-strength opioid, citing concerns that patients can overdose or become addicted.