FROM 1996 TO 2010, Matt Willis says, doctors had a “very liberal practice in prescribing (opioids) … There was essentially a myth we were taught to believe, that opioids were safe and effective for the management of both acute and chronic pain, and that there was little chance of addiction. And that was just plain wrong.”
Now, a community-based coalition called RxSafeMarin, co-founded by Willis, M.D., MPH, the county’s public health officer, in 2014, has started to turn the tide of prescription opioid abuse. Among its other efforts, educating medical personnel about non-addictive, alternative painkillers and standardizing emergency room protocols have led to a 35 percent reduction in opioid prescriptions between 2014 and 2016, Willis says.
The county is also taking legal action against pharmaceutical wholesalers and manufacturers. In May, the Marin County Counsel filed a federal lawsuit against 12 drug companies, alleging they “aggressively marketed and falsely promoted liberal opioid prescribing as presenting little to no risk of addiction, even when [medications are] used long-term for chronic pain.”
At press time, the suit was expected to be transferred from San Francisco to Northern Ohio to join litigation already consolidating more than 400 cases, according to County Counsel Brian Washington. The federal judge is “really pushing the drug companies to settle” with the various cities, states and counties that have filed suit, Washington notes, but litigation could take up to five years if a settlement is not reached by the end of December.
“The county has been aggressively working on multiple fronts on this opioid issue for many years, and we’ve been watching as this wave of litigation has grown,” Washington says. “We figured it was a good time to jump in and raise our hand with the other cities and counties to try to get the pharmaceutical companies held accountable.”
Marin: By the Numbers
The number of prescriptions for opioid painkillers — among them OxyContin, Vicodin and Percocet — exceeded the number of households in 2016 (the most recent data available).
Drug overdoses have far outpaced motor vehicle accidents as the leading cause of death for the last five years; most overdoses involve opioids, including heroin and fentanyl. “For three out of four people using heroin, their addiction began with prescription opioids,” notes Matt Willis.
As the number of opioid prescriptions doubled between 2004 and 2013, so did the number of related overdoses, clinical admissions for addiction to painkillers and emergency room visits.