Wednesday, August 28, 2019

The False Premises of the Ruling Against Johnson & Johnson

This week an Oklahoma judge ruled that Johnson & Johnson should pay $572 million to "Abate" a "Public nuisance" the company created in that state by minimizing the hazards and overselling the benefits of prescription opioids.

The difference between those two decisions partly reflects the difference between broad and narrow understandings of "Public nuisance." But the diametrically opposed rulings also pit a simple narrative of the "Opioid crisis" with a clear set of villains against a more complicated story that's closer to the truth.

Ruling against Johnson & Johnson on Monday, Cleveland County District Court Judge Thad Balkman claimed the "Current stage of the Opioid Crisisstill primarily involves prescription opioids." According to records collected by the U.S. Centers for Disease Control and Prevention pain pills were involved in just 30 percent of opioid-related deaths in 2017.

In 2015, according to the National Survey on Drug Use and Health, about 2 percent of Americans who took prescription opioids, including nonmedical users, qualified for a diagnosis of "Opioid use disorder," a broad category that is not limited to addiction.

According to a 2015 Pain Medicine study, the fatal overdose rate among North Carolina patients who received opioid prescriptions in 2010 was 0.02 percent.

Balkman also thought Johnson & Johnson was wrong to say opioids could be appropriate for treating chronic pain and wrong to suggest that undertreated patients might look like addicts as they desperately sought relief.

Judge Hill concluded that the link between pharmaceutical companies and opioid abuse asserted by North Dakota "Depends on an extremely attenuated, multi-step, and remote causal chain." It ignores the role of regulators who establish rules for opioid use, doctors who exercise independent medical judgment in deciding when and how to prescribe these drugs, and people who choose to take pain pills for nonmedical purposes, the vast majority of whom are not bona fide pain patients.

https://reason.com/2019/08/28/the-false-premises-of-the-ruling-against-johnson-johnson/

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