While critics keep throwing up a false narrative about “ambulance chasing,” self-enriching lawyers, their labors and the civil legal system have proven yet again their effectiveness in wringing financial justice for those harmed by health care giants.

The nation’s largest pharmacy chains have tentatively agreed to pay $10 billion in settlements for dispensing an avalanche of addictive, debilitating, and deadly prescription painkillers.

CVS and Walgreens, which had been among the staunchest holdouts in battling opioid litigation, both defended their business practices and denied any wrongdoing. They blamed doctors for excessive prescribing of powerful opioid drugs, which, federal officials say, fueled an abuse and overdose crisis that is worsening and killed more than 100,000 Americans last year.

Although the federal Centers for Disease Control and Prevention (CDC) has estimated that this public health nightmare has claimed more than 550,000 U.S. lives between 1999 and 2020, pharmacies — led by giants CVS and Walmart —  kept filling orders for hundreds of millions of painkiller pills annually.

They did so, they assert, because they were presented legitimate prescriptions from doctors. But critics slammed pharmacies for filling orders even when they violated their own policies that raised alarm about huge volumes of dangerous drugs going to relatively few users. As the Washington Post reported:

“Walgreens …handled nearly 1 in 5 of the most addictive opioids at the height of the crisis …”

The New York Times reported that the giant companies still must get thousands of claimants representing various governments and Indian tribes to agree to proposed settlement deals:

• “CVS said that under the agreement the company would pay $4.9 billion to states and municipal governments over the next 10 years and about $130 million to tribes …
• “Walgreens said it would pay $4.79 billion over 15 years to the states and $154.5 million to the tribes. It would also pay $753.5 million in lawyers’ fees and costs, over six years. (CVS did not disclose what it would pay lawyers.)”

The New York Times reported that the exact sums involved in the settlement will depend on getting various plaintiffs to agree to a prospective deal:

“It is unclear how many states, municipalities and tribes will agree to these proposals, particularly given how protracted and contentious negotiations have been.”

The announced settlements came after corporations saw how their cases would fare if brought to trial, as occurred in a Florida trial involving CVS, Walgreens, and Walmart, the Washington Post reported, and a lawsuit in California involving just Walgreens:

“[S]ources close to the negotiations told The Post that the companies are expected to agree to a framework similar to the one reached in Walgreens’ settlement with Florida. That deal established requirements, including forming a regulatory system for monitoring suspicious prescriptions, creating a hotline for workers and patients to report inappropriate dispensing, and offering naloxone, a drug used to reverse opioid overdoses. The tentative settlements would allow the companies — among the last left in the national litigation with deep pockets — to avoid further judgments after losses in court. The three were ordered to pay about $650 million earlier this year to two Ohio counties after a federal jury concluded that they played a significant role in the opioid crisis faced by Lake and Trumbull counties. In August, a federal judge in San Francisco ruled that Walgreens ‘substantially contributed” to the city’s worsening drug problem; a trial to determine financial damages [is still to occur].”

The civil awards will be used by states, counties, cities, other governments, and tribes to treat those damaged by opioids, as well in other harm-reduction and public awareness campaigns. Experts with the Pew Charitable Trusts have estimated the terrible economic toll inflicted for each year that the nation fails to quell opioid overdose, misuse, and dependence, including: $35 billion in health costs, $14.8 billion in spending in the criminal justice area, and $92 billion in lost productivity.

Plaintiffs and their lawyers have pursued justice and financial compensation, which may be required to help those harmed with a lifetime of injuries and needs, with thousands of lawsuits. Many of these have been consolidated at the federal level in a court in Cleveland, Ohio, where a judge has tried to get the disputing parties to reach a “global” settlement, akin to what occurred with Big Tobacco.

That has not happened. But negotiations and trials involving an array of parties that plaintiffs hope to hold accountable for their role in the opioid crisis have marched forward for months, Stat, the medical and scientific news site, has reported:

“With settlements already proposed or finalized between some of the biggest drug makers and distribution companies, the recent developments [involving huge drug store chains] could be the among the last multibillion-dollar settlements to be announced. They also would bring the total value of all settlements to more than $50 billion, with most of it required to be used by state and local governments to combat opioids.”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by dangerous drugs, especially prescribed products like addictive painkillers from Big Pharma.

The opioid crisis — fostered for years by Big Pharma, doctors, hospitals, insurers, and others in the U.S. health care system — has entered its latest and notably bad stage with easily and cheaply made, exceedingly powerful synthetic painkillers like fentanyl flooding the country.

Sure, some fear-mongering folks overplayed the possibility that rainbow-colored pills laced with fentanyl would imperil youngsters trick-or-treating for Halloween. It did not. Don’t ignore this, though: Fentanyl is causing serious death and injury nationwide, especially for young folks. They buy street drugs from criminals who try to jack up the high produced by their products by adding fentanyl, which packs a wallop in even the tiniest of doses. Families across the country are dealing with the grief caused by fatal overdoses, sometimes affecting multiple victims.

Talk to your youngsters, calmly and constantly, about the risks of illicit drugs. Let them know that if they have even the least inkling that they or anyone they know may have overdosed to seek out the reversal agent naloxone or Narcan, which authorities have sought to make more widely available — in schools, libraries, fire stations, and pharmacies.

As for the serious issue of pain control and what further steps the nation must take, it is disconcerting to see the halting efforts doctors and regulators are making in determining best practices for prescribing opioids. The CDC has issued new guidelines, offering more flexibility, stressing they are recommendations, and telling clinicians they should dispense powerful painkillers depending on their best medical judgment and the needs of individual patients, the Washington Post reported:

“The new recommendations eliminate numerical dose limits and caps on length of treatment for chronic pain patients that had been suggested in the landmark 2016 version of the agency’s advice, which was aimed at curbing the liberal use of the medication and controlling a rampaging opioid epidemic. Those guidelines cautioned doctors that commencing opioid therapy was a momentous decision for patients. Parts of that nonbinding document were widely misinterpreted, resulting in unintended harm to patients who were benefiting from use of opioids without much risk of addiction. Patients reported they were rapidly tapered off medication by doctors or saw their medication abruptly discontinued, the CDC acknowledged in the new document. Some insurers and pharmacies set rigid limits on duration of prescriptions or dropped patients altogether.”

Hmm, let’s see if medical experts have got it better this time. We have much work to do to quell the opioid crisis and to ensure that millions of people and their elected governments find justice and the practical and economic support they will need for a long time due to the awful damage done by harmful drugs.