Great Falls discusses opioid litigation; suits filed in federal court on behalf of Cascade, Gallatin counties

First responders and the city’s judge asked City Commissioners to consider pursuing litigation against opioid manufacturers, if for no other reason than to make a statement.

Great Falls Police Chief Dave Bowen said “I’m a guy about principles.”

Bowen was more animated and emotional than he usually is in city meetings while discussing the impact of opioids. He said it’s the principle of what the drug companies have done and he wants to send a message to them.

“We’re literally drowning in opioids,” he said. “This crap’s gotta end. I’m tired of this. Just make a statement. My folks out there on the line everyday, they’re struggling.”

Great Falls Fire Rescue Chief Steve Hester said they’ve noticed an uptick in calls related to overdoses.

“It’s not getting any better,” Hester said.

Great Falls Municipal Judge Steve Bolstad said that around 2005, when he was a prosecutor, they started noticing people getting busted with pills and “we didn’t know what to do with them.”

He said he regularly sees people in his court who are coming down from prescription drugs and crimes like theft and domestic issues that are related to opioids.

“This is a huge problem,” Bolstad said. “I would really encourage the city to look at this.”

Stuart Purdy of the California office of Simon Greenstone Panatier Bartlett, P.C. presented to the City Commission during their Tuesday work session on why the law firm was pursuing litigation against the manufacturers and has been working with cities and counties to file claims on their behalf. He said they’re working with 25 Texas counties out of the firms Texas office and last week, Cascade County Commissioners approved a retention agreement with the firm, as well as Kovacich Snipes P.C. of Great Falls; Edwards, Frickle and Culver of Billings; Beck, Amsden and Stalpes PLCC of Bozeman; and Boone Karlberg P.C. of Missoula.

The firms have already filed a case in federal court on behalf of Cascade and Gallatin counties. The suit was filed last week on behalf of Cascade County and amended on Friday, Dec. 1, to add Gallatin County as a plaintiff.

This week, Montana Attorney General Tim Fox filed suit against Purdue Pharma, an opioid manufacturer.

The suits are largely accusing the opioid manufactures of deceptive marketing practices for downplaying the highly addictive nature of the drugs while encouraging physicians to use the drugs for long-term care.

Purdy is originally from Great Falls and is a CMR graduate. On Tuesday, he told commissioners that he wanted to represent his hometown in their fight against the opioid manufactures.

Purdy said opioids were developed in the 1970s and 1980s, but were only used for severe injuries and in limited doses or end of life care. There wasn’t an opioid epidemic then, he said.

The shift started in the 1990s, Purdy said, when Purdue Pharma was in danger of losing their patent on MS Contin, the pioneer drug.

The drug wasn’t a big seller at the time, he said, so the company embarked on a $1 billion marketing campaign that involved influencing the education of physicians and putting out papers promoting the drugs, leading to misinformed doctors.

“They tried to sell to everyone that these drugs could be used for long-term care,”
Purdy told commissioners. “That marketing campaign was wildly successful.”

According to the suit filed in federal court on behalf of Cascade and Gallatin counties, “essentially each defendant ignored science and consumer health for profits. Defendants’ efforts were so successful that opioids are now the most prescribed class of drugs generating $11 billion in revenue for drug companies in 2014 alone.”

One of the major questions from the city’s legal staff and Commissioner Bill Bronson, who is a lawyer, was damages and causation.

“We’re going to need to prove the damages to the city of Great Falls,” Purdy said.

To do so, he said they’d look at the city budget, use of Narcan by first responders, calls for service data, healthcare data and other information. He said there will be some readily identifiable areas, but a lot of gray areas.

Purdy’s firm has hired experts who do pharmaceutical analysis of damages on macro level and they say they can distill that down to the micro level.

According to the federal lawsuit filed on behalf of Cascade and Gallatin counties, the counties “are responsible for programs and services which require the Counties to expend resources generated through state and federal aid, property taxes, fees and other permissible revenue sources.”

The counties provide programs and services like the Missouri River Drug Task Force, the City-County Health Department and court services, which become more burdened due to the costs associated with the opioid abuse, according to the court documents.

According to the lawsuit, Gallatin County Court Services estimates that it spends about $103,666.00 annually of county tax dollars related to opioid abuse. That includes two re-entry beds at $48,000; pretrial defendants at $14,000; drug testing for $10,000; treatment court at $21,66 and misdemeanor supervision-post-sentencing costs at $10,000.

According to the lawsuit, the Missouri River Drug Task Force reported that there were 53 calls for service for opioid overdoses from September 2015 through September 2016, and 58 overdoses during that time period in 2017. Also, American Medical Response, an ambulance service in Gallatin County, reported these yearly ambulance or fire emergency responses where Naloxone/Narcan was administered: 2014, 14; 2015, 30; 2016, 36.

The Montana State Forensic Science division has reported that from Jan. 1, 2014 through Nov, 17, 2017, its toxicology and chemistry sections analyzed specimens submitted by law enforcement agencies and found opiates in 1,643 cases.

If the lawyers are successful and win settlements for the city, those funds could be used for Narcan for the police and fire departments, prevention and treatment programs.

The lawyers are proposing a contingency agreement, meaning the city incurs no cost unless they win in court and the lawyers would recoup their fees from the winnings. Typically, the lawyers get 33 percent of the winnings, but that is up for negotiation with the city. Cascade County’s agreement is 20 percent.

City Attorney Sara Sexe said she had concerns on staff time that would be needed for the data gathering. Mayor Bob Kelly asked if the city can leave the suit if it becomes too burdensome for city staff and resources. Sexe said the city can withdraw.

Commissioner Bill Bronson said he’s seen the impact through his law practice.

“We have seen this monster develop.”

He said the legal strategy against the opioid manufacturers has parallels to lawsuits that states won against tobacco companies. In those cases, cities and counties didn’t see much of the settlement money, he said.

If the city was directly involved, it could potentially win substantial settlements from the opioid companies.

“We could put that money to good use,” Bronson said, for the drug take back program, Narcan and other programs designed to prevent and fight the opioid problem. “I think it would behoove us to explore it,” Bronson said.

Narcan packs have two doses and range in cost from about $50 to $80, Purdy and Bowen said.

A state law passed in the 2017 legislative session allowed wider use of Narcan by first responders, schools and those who might be at risk of exposure to get prescriptions for Narcan.

Officer Clint Houston with GFPD said the department was receiving training in recognizing an opioid overdose and the proper administration of Narcan.

It’s helpful for first responders to be able to get a prescription for Narcan, Houston said, since they might encounter someone overdosing on opioids and they also run the risk of being exposed while on the job and experiencing an accidental overdose.

Great Falls Fire Rescue and Great Falls Emergency Services carry Narcan.

Houston said Narcan doesn’t have side effects so it won’t hurt someone if Narcan is administered to someone experiencing something other than an overdose, but it’s only effective for heroin, opioids and synthetic painkillers. It’s a receptor blocker that delays an overdose for about 45 minutes, giving first responders time to get a patient to the hospital for the appropriate medical care.

“This protects us and will help protect our community,” Houston said.

GFPD officers haven’t had to use Narcan yet, Houston said, but Great Falls Emergency Services has.

Justin Grohs, GFES operations manager, said that as of Nov. 8, 2017, GFES has administered Narcan 41 times this year. During 2016, Narcan was administered 51 times. Those figures are county-wide, but Grohs said the bulk of incidents were in the city.

Commissioner Bob Jones, a former GFPD chief, said that since he’s leaving office at the end of the month, he’d rather see the matter go before the new commission since it will likely be a long haul.

Commissioner Tracy Houck said the data gathered through the litigation process could also be used in writing grant applications for other resources to deal with opioid related issues.

“A statement needs to be made,” Houck said. “We kind of have a duty to figure out how to be involved.”

Kelly said his concern is that joining the litigation is a policy decision and wants to have some criteria established for when the city would join litigation in the future.

City Manager Greg Doyon asked where are the physicians in all of this, though that question didn’t get discussed during Tuesday’s work session.

Doyon said he wants to pull together department heads who are most affected by the opioid crisis and make sure the city can identify the impacts and have some discussion to develop a plan on how they’d use the settlement money if it materialized.

“I think it’s worthy of our consideration,” Doyon said.

The commission made no decisions on whether to pursue the opioid litigation, but Kelly told staff to put it on the docket for early 2018.