The largest civil trial in U.S. history is scheduled to begin in a matter of days, putting those who made, marketed, distributed and dispensed prescription painkillers under the legal spotlight. But those on the front lines of the opioid epidemic are already looking beyond the courtroom to the massive settlement they expect will ultimately resolve the case.
Experts have little doubt it would be the most complex payout the country has ever seen. It would exact so much, from so many companies. And it would need to do so much for so many people, starting with the 2 million Americans ensnared in addiction.
A settlement in the case known as Multidistrict Litigation 2804 would have many pricey pieces. The total cost could easily range upwards of $100 billion.
It would need to fund potentially for years counseling and addiction treatment for those ready to try it.
It would have to broaden access to the opioid-reversal drug naloxone and underwrite the development of newer, more effective rescue drugs, so that those who overdose have a chance to get clean.
It could pay for drug abuse prevention campaigns for the public, safe-prescribing seminars for doctors and abuse awareness programs for pharmacists.
It would probably include drug screening for pregnant women as well as treatment for infants exposed to opioids in the womb.
It might fund support groups for families of the addicted and grief services for those left behind.
It would reimburse state and local health departments for the money theyve spent treating millions of victims.
Thats not even an exhaustive list. And, of course, theres no amount of money that can bring back the 400,000 Americans who lost their lives to opioids.
A global settlement would require the consent of the roughly 35,000 plaintiffs in the case as well as the 348 pharmaceutical companies, mom-and-pop drugstores, professional medical associations and other assorted individuals they have accused of fueling an epidemic of death and dependence.
U.S. District Judge Dan Aaron Polster, who presides over the case from his Cleveland courtroom, has leaned hard on all sides to settle before jury selection begins Wednesday. Thats much easier said than done.
To appreciate the magnitude of the challenge, consider the plan Oklahoma devised to address the opioid crisis within its borders. The state proposed an expansion of its opioid addiction treatment services, public awareness campaigns aimed at addiction prevention and proper medication disposal, and funding for programs aimed at treating pain with non-opioid therapies, among other elements.
The projected 20-year cost came to $17 billion and thats for a state with just 1% of the U.S. population and an opioid overdose death rate 30% lower than the national average.
There are a million moving parts to this case and its settlement, said University of Georgia litigation expert Elizabeth Burch. And as soon as you figure it out, it changes on you.
