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Coalition launched to determine if drug makers, distributors broke laws amid opioid epidemic

Written statements related to opioid crisis provided

HOUSTON – Texas and 40 other states launched a coalition in June to determine if drug makers and distributors broke any laws amid the opioid epidemic.

In September, Texas Attorney General Ken Paxton announced subpoenas and additional requests had been served to eight companies that manufacture or distribute the highly-addictive painkillers. An investigation is underway and it's one that's now decades in the making.

Back in the '90s, a promotional video came out titled "I got my life back!" In the video, a doctor touts opioids as the best and strongest medications for pain. He endorses OxyContin, saying opioids don't have serious medical side effects.

Fellow physicians got on board, and patients looking for relief from pain began asking for that opioid by name.

"Taking it back to the '80s and '90s, it was a perfect storm where everybody was guilty, everybody had their hand in the cookie jar," pain management specialist Dr. David Kim said.

He said doctors wanted to help, drug companies wanted to sell product and even federal agencies were on board and mandated doctors treat pain more aggressively.

Opioids work by turning off pain receptors in the brain and there was some very early research suggesting addiction shouldn't be a concern.

"What we've done, literally, is done the largest experiment in human history on 300 million people and we've been doing it for 30 years, and now we have data and the data is not very pretty," Kim said.

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It's not just the doctors who have to be careful. The patients have to be careful, too. While they may not become addicted to the medications, leaving them stored unused in the home, or giving them to a loved one thinking it's going to help them could ultimately be harming them.

"We put them in the medicine cabinet. Those can be a real problem, whether it's teenage children or college-aged children who begin to experiment with medication," said Dr. Adam Bruggeman, who is with a San Antonio treatment center.

In spite of the risk, opioids are still the best option for some patients in pain and those with lifetime or terminal illnesses.

"As physicians, if we do decide to initiate opioids, we have to do our due diligence to protect society and our patients," Kim said.

Doctors are now advised to dispense fewer pills, choose the least potent or addictive medication to manage the pain and even play detective to determine if patients are abusing their prescriptions.

In some places, that means doctors run a patient's name through a database before prescribing narcotics and look up a patient's prescription history.

Bruggeman agrees physicians and drug companies both have played a role in the country's opioid epidemic, but now he says it's up to doctors and lawmakers to stop the pharmaceutical industry from influencing the practice of medicine.

"We really need to be smart about who we allow in our doors and how we make our decisions," Bruggeman said.

Since the launch of the multistate investigation into pharmaceutical companies, many companies turned down KPRC sister station WJXT's request for on-camera interviews.

In written statements related to the opioid crisis, Purdue Pharma says, "We share public officials' concerns about the opioid crisis and we are committed to working collaboratively to find solutions."

The Purdue spokesperson also said, "OxyContin accounts for less than 2% of the opioid analgesic prescription market nationally, but we are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone -- all important components for combating the opioid crisis."

Jansenn Pharmaceuticals says, "We recognize opioid abuse is a serious public health issue."

Teva Pharmaceutical states it "is committed to the appropriate promotion and use of opioids. We have programs in place that educate prescribers, pharmacists and patients on the responsible and safe use of these products."

Last month, Attorney General Paxton and his counterparts served investigative subpoenas -- also known as Civil Investigative Demands (CID) -- on drugmakers Endo, Janssen, Teva/Cephalon, Allergan and their related entities, along with a supplemental CID on Purdue Pharma. Separately, the coalition sent information demand letters to opioid distributors AmerisourceBergen, Cardinal Health and McKesson.

"Protecting Texans is a top priority of my office. The goal of this phase of our investigation is to collect enough information so that the multi-state coalition can effectively evaluate whether manufacturers and distributors engaged in unlawful practices in the marketing, sale, and distribution of opioids," Paxton said. "We'll determine an appropriate course of action once it's determined what role these companies may have played in creating or prolonging the opioid crisis."