The City of Newport and Jackson County Quorum Court are just two of the collection of cities and counties across Arkansas joining a litigation to hold accountable the nation’s leading pharmaceutical companies over their misleading and deceptive marketing of prescription opioid painkillers.
In a unique and strategic move, the Association of Arkansas Counties (AAC), Arkansas Municipal League (AML), and Arkansas Public Entities Risk Management Association (APERMA) have retained the same outside law firms to pursue litigation against the drug companies on behalf of the local governments of Arkansas. To date, 69 of the 75 counties have signed on to the litigation.
“AML membership comprising more than 80 percent of the population living in Arkansas’ cities and towns have signed contracts and joined the Arkansas opioid litigation,” said AML Executive Director Don Zimmerman.
Cumulatively, the AAC, AML, and APERMA represent virtually every city and county in the state of Arkansas. This unique legal collaboration brings together county judges, mayors, sheriffs, police chiefs, fire chiefs, first responders, and coroners – officials best positioned to lead the charge against opioids. As a unified force in this litigation, local government in Arkansas will have the ability to end this high-priced epidemic and to heal our communities from the ravages of opioid abuse.
The AAML, AAC, and APERMA were encouraged last week when Arkansas Attorney General Leslie Rutledge announced her intention to launch an investigation into the opioid crisis. Throughout her time in office, Rutledge has been a leader in response to the opioid epidemic. She introduced a first-in-the-nation educational tool – Prescription for Life – that is free to high schools across Arkansas. Additionally, the Attorney General sponsors statewide drug take-back initiatives and the annual Prescription Drug Abuse Prevention Summit. The summit provides free training and educational opportunities for law enforcement officers, medical professionals, pharmacists, and educators on prescription drug abuse prevention and treatment.
Given the Attorney General’s vast knowledge and expertise on the matter, the state’s investigation adds strength to the opioid litigation that is unprecedented.
Arkansas Governor Asa Hutchinson and Arkansas Drug Director Kirk Lane also have shown great leadership in response to the opioid epidemic. Governor Hutchinson and Director Lane have supported legislation allowing pharmacists to dispense naloxone – an antidote for opioid overdose – without a prescription. They also helped establish a statewide protocol for tracking the prescribing and dispensing of opioids, allowing law enforcement to watch for trends and anticipate problems, and they have worked to establish more drug courts, among other initiatives, to combat the opioid epidemic.
“Our hope is to work cooperatively with all governmental entities in Arkansas that have been affected by the opioid epidemic, including this state,” said AAC Executive Director Chris Villines. Unity among Arkansas counties and cities has created a force to be reckoned with that can put an end to this epidemic. “Through cohesion and cooperative efforts, we hope for a united Arkansas approach to this litigation that would force drug companies and the courts to take Arkansas seriously – cities, counties, and the state.”
A 2016 analysis by the U.S. Centers for Disease Control and Prevention (CDC) shows all but nine of Arkansas’ 75 counties had overall opioid prescribing rates higher than the national average of 66.5 prescriptions per 100 people. As a state, Arkansas has an opioid prescription rate of 114.6 per 100, second only to Alabama 2016 average of 121 per 100 people. In the same year, Arkansas saw the number of opioid-related deaths rise from 287 to 335, according to data from the Centers for Disease Control and Prevention (CDC). Arkansas Health Department Director Nate Smith reported to state lawmakers that 235.9 million pills were sold across the state that year. Arkansas is in the top twenty percent of states that prescribe the most painkillers per capita.
Smith gave a report to lawmakers in a Joint Interim Committee on Public Health at the State Capitol reporting that enough opioids are now being sold in Arkansas for every man, woman and child to take 80 pills each over the course of a year.
In 2011, Arkansas joined the effort to monitor opioid prescriptions, with the assistance of the Electronic Prescription Monitoring Program (PMP), the state-run electronic database used to track the prescribing and dispensing of controlled prescription drugs to patients. This encourages practitioners to monitor the dispensing of opioids and prescription painkillers such as oxycodone, hydrocodone codeine and fentanyl.
Under the program, each time a controlled substance is handed out to an individual, the dispenser submits the information to the state’s central repository weekly, providing a Sunday through Saturday window into the misuse and abuse of prescription drugs. It also gives doctors and other medical practitioners, as well as law enforcement agents and other authorized individuals and agencies, access to prescription drug data to help ensure the legal use of controlled substances in health care.
Recently Republican lawmakers Sen. Jeremy Hutchinson of Little Rock and Rep. Kim Hammer of Benton updated the 2011 law, sponsoring Act 820 of 2017 that now mandates prescribers of opioids to enter information on controlled prescription drugs to patients into the state’s PMP database.
In 2013, Arkansas lawmakers followed up the PMP legislation with Act 1331, which prevents Arkansas patients from obtaining opioids and other addictive drugs through forgery, fraud and deceit to prevent doctor shopping. However, it was the 2015 session when lawmakers introduced at least a half dozen bills that addressed the emerging health crisis. The key legislation was the Arkansas Prescription Drug Abuse Act, which allows the Department of Health to develop algorithms to determine if a patient is being prescribed opioids within a 30-day period by more than three physicians. It also lets prescribers delegate access to the PMP database, sets up opioid prescribing guidelines for emergency departments, and provides immunity for good faith reporting of suspected drug diversion.
Other legislation in the 2015 session allowed wider access to the PMP database, including giving law enforcement investigators access to information to aid in criminal investigations. Other key bills gave healthcare professionals access to naloxone and immunity from administrating the drug that blocks opiate receptors, and created a legislative task force to make sure those caught up in the criminal justice system can get behavioral treatment for substance abuse disorders.