Need-to-know on the opioid trial: Johnson & Johnson 'brainwashing,' Oklahoma's strategy and a self-destructing email patent

J&J stands accused of "brainwashing" doctors into overprescribing its powerful opioids, Oklahoma Attorney General Mike Hunter said. (Pixabay)

Oklahoma prosecutors have already bagged two settlements from drugmakers it claimed helped fuel the state’s opioid crisis through corporate greed and deceptive marketing. Now the state is getting its crack at a third in court, and headlines are exploding—not only across the U.S., but overseas, as other countries acquire their own opioid addiction problems.

Oklahoma’s landmark bench trial against Johnson & Johnson and subsidiary Janssen Pharmaceuticals kicked off Tuesday with opening statements from Attorney General Mike Hunter accusing the company of a “deceitful, multibillion-dollar brainwashing campaign” to boost sales of its powerful and potentially addictive opioids.

While Purdue Pharma and Teva Pharmaceuticals have settled for a combined $355 million, the J&J trial could have far-reaching implications for all three companies’ chances in thousands of other lawsuits, including some 1,600 consolidated in Cleveland. Testimony in that set of suits, leaked Wednesday, put Purdue's ex-CEO Richard Sackler in the hot seat for a self-destructing email patent, among other things.

Here’s all the latest news coming out of the courthouse and other relevant articles.

Driven by corporate greed, J&J induced doctors to boost opioid prescriptions to treat unapproved ailments and exacerbated the state’s dependence epidemic, Hunter said in the state’s opening remarks. Hunter said the potent combination of an oversupply of opioids and doctors overprescribing those painkillers led to the “worst man-made public health crisis in the state’s history.”

For its defense, J&J is expected to target the state’s broad use of public nuisance law, and in the company’s opening statement, attorney Larry Ottoway disputed claims that J&J targeted children in its marketing.

Oklahoma’s unique strategy of painting J&J as a public nuisance could offer a blueprint for other states to pursue drugmakers in court if it proves successful. Hunter said the company should be on the hook for damages between $12.7 billion and $17.5 billion over the next 20 to 30 years for its role in escalating the opioid crisis, but some observers said the state’s strategy could face difficulty in front of a judge.

The father of a University of Oklahoma football player who overdosed on painkillers and died in 2011 is expected to testify Wednesday as state’s evidence. State prosecutors will likely call Craig Box, the father of OU linebacker Austin Box, to testify about his son’s overdose death at the age of 22. Hunter said the state would argue that 4,000 Oklahomans died of overdoses between 2007 and 2017 in part because of J&J's aggressive marketing. Another part, the state says: J&J's supply of active ingredients for those painkillers, which helped fuel other companies' marketing habits.

Purdue and its billionaire founding family are off the hook in Oklahoma to the tune of $270 million, but revelation of the company’s patent for a "self-destructing document and email messaging system” could spell trouble for the company’s future defense. A newly unsealed deposition from former CEO Richard Sackler in March revealed the existence of that patent, which dates to 2007. The system worked by attaching a virus that would destroy emails or documents at a predetermined time, even if they'd been forwarded to people outside the company. The patent explicitly noted the system's utility in dealing with litigation. In his leaked deposition, Sackler said he was unaware whether the patent had been issued and that he wasn’t involved in the application.

Sackler, who's named directly in many of the lawsuits against Purdue, was warned against becoming the “Pablo Escobar of the new millennium” in the company’s aggressive marketing of painkiller OxyContin, according to his March deposition. In an email, an anesthesiologist friend told Sackler they had heard of a school-age girl being approached to illegally buy OxyContin, which was referred to as “sort of like heroin.”

The scrutiny on Purdue hasn’t only been stateside but also abroad, with the company’s international arm now accused of paying an Italian doctor to tout OxyContin in that country. Mundipharma, the drugmaker’s Europe-based affiliate, allegedly funneled money into shell accounts owned by Dr. Guido Fanelli in an effort to promote and sell OxyContin, Italian investigators said. Fanelli called Mundipharma and other pharmaceutical managers he worked with the “Pain League” for their efforts in touting opioid use.

Drugmakers aren’t the only ones feeling the pinch from thousands of lawsuits as the American Pain Society, an opioid research organization, mulls bankruptcy in the face of court pressure. The society is one of a group of nonprofits targeted for accepting pharma donations; prosecutors say the contributions skewed their results and helped companies push their drugs. The American Pain Society was responsible for the concept of pain as a “fifth vital sign,” which has been linked to opioid overprescribing.