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Closing Arguments To Begin In West Virginia's Opioid Crisis

SARAH MCCAMMON, HOST:

For the first time, a federal trial against the companies that sold and distributed opioids is going to closing arguments. It's happening today in Charleston, W.V. Three of the nation's biggest drug wholesalers face claims that they shipped millions of pills to rural towns and cities, ignoring red flags as addiction and overdose deaths exploded. At the same time, these companies hope to convince thousands of communities across the country to end their opioid lawsuits in exchange for a $26 billion national settlement. NPR addiction correspondent Brian Mann is in Charleston, W.V., this morning and joins us now. Good morning, Brian.

BRIAN MANN, BYLINE: Good morning, Sarah.

MCCAMMON: Brian, I want to dig into why this case in West Virginia matters so much. But first, let's talk about the people there in West Virginia. How has this opioid crisis that you've been covering damaged these communities?

MANN: It's been uniquely painful here. You know, the trial focuses on Huntington, W.V., and surrounding Cabell County - home to about 90,000 people. And what we know because of information disclosed during this trial is that these three drug distributors - AmerisourceBergen, Cardinal Health and McKesson - they shipped tens of millions of these highly addictive pills to Huntington. Experts say that sparked an addiction crisis where 1 in 10 people is now opioid dependent and that addiction is now being fed with street heroin and fentanyl. I met Shana Damron (ph), who lives on the street there in Huntington.

SHANA DAMRON: I mean, that fentanyl is no joke. And it's just a split second, you know? And every time we stick a needle in our arm, we're taking a 50-50 chance, you know? You know, we could die.

MANN: And people are dying, Sarah. Fatal overdoses have surged 40% in West Virginia, outpacing the rise of drug deaths around the country.

MCCAMMON: What have we learned so far during this trial, Brian? And why did these companies ship so many pills?

MANN: What the companies say is the fault really lies with doctors who wrote all these prescriptions and with government regulators who failed to intervene. But this trial has forced these firms to disclose a lot of internal documents showing how the industry operated. A lot of it's embarrassing. For one thing, just the sheer quantities of pills shipped as addiction rates surged - experts I've spoken to say that's hard to justify. We also learned executives at AmerisourceBergen shared an email mocking people with addiction, calling them pill-billies (ph). Another document showed executives at McKesson urging their safety teams to avoid using the word suspicious when describing big opioid orders from pharmacies, even when those orders did appear suspicious.

MCCAMMON: And last week, these companies, along with Johnson & Johnson, agreed to a tentative national opioid settlement worth $26 billion. Given that deal, why is this case still going forward?

MANN: Yeah, that's confusing. First of all, Huntington and Cabell County here in West Virginia just don't plan to sign on to that national deal. These communities say their recovery alone from this opioid crisis will cost more than $2 billion. And officials in some other parts of the U.S. have also signaled they just don't think that national settlement provides enough money. This case here in West Virginia is also serving as a kind of legal testing ground. The claim being heard is that these companies created what's known as a public nuisance under the law by shipping all of these pills. This is going to test whether that public nuisance rule law will be applicable in cases like this all over the U.S.

MCCAMMON: So if these drug companies lose, if they're forced to pay up, where could the money go?

MANN: You know, one of the things that's heartbreaking in covering this opioid epidemic is how much the public health fight is happening on a shoestring budget. Ninety-three thousand people died across the U.S. from these overdoses last year, but addiction treatment programs operate on year-to-year grants, on donations, often with volunteers. I spoke about this with Jennifer Chapman, who works at a shelter in Huntington called Lily's Place that cares for women who used opioids while they were pregnant. Their babies are born with opioid dependency. It's a desperately needed service, but she says it's a fight just to keep the doors open.

JENNIFER CHAPMAN: It's always been kind of a struggle. But this past year with the pandemic, it has been harder. Everyone had to worry about their own finances - people being off work and all that. So it was kind of a struggle. But we're still here (laughter).

MANN: So, you know, if the federal court here in Charleston does rule against these companies, finds them liable, it could mean a lot more funding for Lily's Place and other programs, things like supportive housing and medication therapy, for people with opiate addiction. And again, Sarah, people say all of that is desperately needed right now.

MCCAMMON: That's Brian Mann, who covers addiction for NPR. He's in Charleston, W.V., this morning for the first closing arguments in a federal opioid trial. Thanks so much, Brian.

MANN: Thank you, Sarah. Transcript provided by NPR, Copyright NPR.