ROBERT SIEGEL, HOST:
Two California counties and the city of Chicago are suing the makers of prescription pain medications such as OxyContin. They charge the companies have contributed to an epidemic of prescription drug abuse. In California, the lawsuit was filed by Orange and Santa Clara counties on behalf of the entire state. Emily Green reports.
EMILY GREEN, BYLINE: The first time she tried a painkiller, Nicole Dowdell went numb.
NICOLE DOWDELL: It's a feeling of, like - kind of a relief. Like a, ahh, kind of thing.
GREEN: That was three years ago, and Nicole, now 25, has been trying to get her life on track ever since. A doctor gave her the drug Norco after she severely cut her finger and had surgery. Within a month of taking the drug for the first time, she was addicted.
DOWDELL: Once you start it, you try to milk the situation for what it is. And I was just going to different doctors for different things and getting the medication.
GREEN: For pain in her back - for headaches - for anything. She went from taking it by mouth to snorting it. She's far from alone. Addiction to painkillers is a national epidemic according to the Centers for Disease Control and Prevention. Nicole lives in Santa Clara County, just outside of San Francisco. The number of opioid-related deaths there tripled from 2003 to 2013, says assistant County Counsel Danny Chou.
DANNY CHOU: The reason that this crisis has occurred is based on the decades-long marketing plan by these drug companies to create a market for these drugs that never should have existed. And this has spawned a new generation of addicts and abusers.
GREEN: Chou says Santa Clara County is spending millions of dollars in its public hospitals to treat patients suffering from addiction and overdoses. It's also seen a rise in crime. And he wants the drug companies to pay, like the tobacco companies did in the 1990s after they were sued. The lawsuits filed by Santa Clara and Orange counties as well as Chicago accuse the pharmaceutical manufactures of purposefully downplaying the risks of painkillers. Chou says the companies secretly funded what look like mutual advocacy organizations like the American Pain Foundation to promote the drugs.
CHOU: They're the ones who deceive the doctors about the risks and benefits of opioid drugs. And they also deceive patients who then demand these drugs from the doctors. Ultimately, I don't think that the problem could be resolved until doctors and patients get accurate information. You have to start at the source.
GREEN: None of the five pharmaceutical company sued would agree to an interview. In an e-mailed statement, Johnson and Johnson said its pain medications give doctors and patients important choices to help manage the debilitating effects of chronic pain, and that it's committed to supplying providers with accurate information.
ANNA LEMBKE: It's not just the pharmaceutical companies. It's really the whole healthcare industry.
GREEN: Anna Lembke is director of Stanford University's addiction medicine program. She says, for starters, most doctors don't think about addiction. Also, insurance companies pay doctors for the number of patients they see, and prescribing a pill is easy and quick.
LEMBKE: Now you add to that, the pharmaceutical companies aggressively marketing these miracle cures for chronic pain, plus patients coming in saying I'm in terrible pain, won't you help me? So you've got Vicodin over here - you prescribe it. Your patient comes back next time and says thank you so much, doctor. That worked great. I feel so much better. Well, you're going to keep prescribing it.
GREEN: As the lawsuits against the drugmakers advance, a key question will be who's to blame - the patients who ask for it, the doctors who prescribe it, or the companies that create and market it? For NPR News, I'm Emily Greene.
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