(Reuters) - Gail Box vividly remembers the day in May 2011 when she first learned her 22-year-old son Austin, a University of Oklahoma linebacker, was abusing opioid painkillers: It was the day he died of an overdose.
In a few months he had gone from taking pills prescribed for a back injury to illicitly obtaining more of the addictive drugs from acquaintances.
“We did not know he was abusing,” she said. “At that time, there was a lot of over-prescribing, and I think people in his life were able to get him opioids.”
The question of why painkillers flooded into Oklahoma and the rest of the country will be the a central issue in a trial beginning Tuesday in Norman, Oklahoma, pitting the state against two drugmakers it accuses of fueling the epidemic: Johnson & Johnson and Teva Pharmaceutical Industries Ltd.
Oklahoma Attorney General Mike Hunter’s $17 billion lawsuit is the first to go to trial of more than 2,000 actions by state and local governments accusing opioid manufacturers of contributing to an epidemic linked to a record 47,600 overdose deaths in 2017, according to the U.S. Centers for Disease Control and Prevention.
The state will seek to convince Cleveland County District Judge Thad Balkman to find that the companies created a public nuisance by using deceptive marking that downplayed their drugs’ addictive risks while overstating their benefits. Balkman will rule following the trial, which will last eight weeks.
The state resolved related claims against OxyContin maker Purdue Pharma LP in March for $270 million.
J&J and Teva deny wrongdoing, arguing the state lacks evidence linking any marketing they did to doctors writing unwarranted opioid prescriptions.
They also argue that even if they falsely marketed their products, the state cannot prove they caused the opioid epidemic given the role doctors, patients, pharmacists and drug dealers played in it.
“The FDA-approved labels for these prescription pain medications provide clear information about their risks and benefits,” New Brunswick, New Jersey-based J&J said in a statement. “The allegations made against our company are baseless and unsubstantiated.”
Israeli drugmaker Teva in a statement said it has in no way contributed to opioid abuse in Oklahoma and will vigorously defend itself.
In the wake of Purdue’s March settlement with Oklahoma, the state dropped many of its claims against the other two defendants and shifted its focus primarily to J&J, which it claims “acted as the kingpin behind this public health emergency.
The state claims J&J and Teva deceptively marketed opioids with Purdue by retaining prominent doctors to give talks advocating use of opioids to treat chronic rather than short-term pain. It also says the companies funded groups that purported to be independent and these groups in turn promoted the misrepresentations.
The state claims J&J even marketed painkillers to children. It says the company, which formerly marketed the painkillers Duragesic and Nucynta, also grew and imported the raw materials to make the drugs.
The Oklahoma case is being closely watched by plaintiffs in other opioid cases, particularly some 1,850 mostly municipal and state governments that have sued the same drugmakers in federal court in Ohio. The judge in that litigation is pushing the parties to reach a settlement agreement ahead of a scheduled October trial.
Some plaintiffs’ lawyers have compared the opioid cases to litigation by states against the tobacco industry that led to a $246 billion settlement in 1998.
Paul Hanly, a lead lawyer for the plaintiffs in the Ohio litigation, said the Oklahoma trial could have major implications for a nationwide settlement.
“We will have an opportunity to see how these theories play out,” he said. “Anyone who cares about public health issues should care about how the industry, or a portion of the industry, fares in this case.”
Box said she believes “greed” in the pharmaceutical industry caused the epidemic. Box, whose husband, Craig, will testify, said she hopes any money the state recovers can be used to fund treatment and research to fight opioid addiction.
“Those are the things I’m hoping come out of this,” she said. “Because at least myself and other families who lost loved ones, nothing is going bring them back.”
Reporting by Nate Raymond in Boston; Editing by Scott Malone and David Gregorio