CHARLESTON – Wrapping up the plaintiff's case, Huntington Mayor Steve Williams provided emotional testimony detailing his experience in handling the opioid epidemic.
“We had individuals saying we were the epicenter of the opioid epidemic and that smacked me in the center,” Williams said during his sometimes tearful June 30 examination by attorney Anne Kearse. “The hardest part of this is dealing with the family members who have lost someone to this and are lost."
In 2017, Cabell County and the City of Huntington sued the three largest pharmaceutical distribution companies – AmerisourceBergen, Cardinal Health and McKesson Corp. – claiming the companies were largely responsible for the opioid crisis after the companies shipped more than 81 million hydrocodone and oxycodone pills to the county of just 100,000 residents between 2006 and 2014.
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Williams currently is serving his third term in office, holding the position since 2013. Not long into his first term, Williams said former Police Chief Skip Holbrook reported a “serious problem of proliferation of opioid prescription pills, as well as heroin.”
The mayor said the United States Attorney General had made it known to Huntington that the police department was one of the top departments. He said he had complete faith in the department and its work combating the increase drug use.
“I understood it was a growing problem, but once again I have absolute faith in our police department and the level of partnership they had with other agencies,” Williams said. “While they didn’t have it under control, I wouldn’t want anyone else dealing with the issue.
"Our police needed to have all the support that we could muster to help them.”
Williams said at one point, he was asked to go on a SWAT raid, something he had never done before. He said he believes there were a reported 500 grams of heroin shipped in and upon arrival to the home, there was only about 35 grams left.
“I was scared witless because I saw the dangers our officers were in,” Williams said. “There was a market here, and we had to do everything we could do to take it on.”
Williams said his office started receiving messages from worried constituents.
Williams said the police department, while not interfering with federal law enforcement, was finding low level distributors and sellers. He said more than 200 arrests were made in a 90-day period.
“I was feeling pretty good," Williams testified. "I thought, ‘they’re getting the message not to come here. You can’t arrest your way out of this.”
Williams said it was time that it was said, “we have a serious, serious issue with addiction here.” And he met with area ministers and asked to bring the churches together one day for a prayer.
“I found in most difficult times, prayer is most enlightening to me and most comforting,” Williams said, pausing to wipe away tears. “And I know the nature of our community. [We] pray[ed] for delivery of those fighting addiction to be delivered out of opioid addiction, safety of officers and prayer for those involved in peddling drugs.”
Williams said there were several different people doing different things.
“Somebody needed to take the lead,” Williams said. “In Huntington, we were uniquely positioned to do that.”
A strategic plan was first put together in 2015 and revised in 2017, laying the framework for the community to work together collaboratively.
Williams said officials struggled with having real time data because the CDC information was two years old. The county started its own database with real-time data. The city started going after grants. The health department expressed the need of a harm reduction program, Williams said. The city partnered to sponsor a syringe exchange program.
Williams said hospitals, Marshall University, churches and the entire community stepped up worked together. He said he saw the shift in the community.
Recalling the experience of seeing someone at the lowest point of their life and going on to recovery and thriving, Williams, again, tried to hold back his tears.
“When I look at what he’s done and so many others, it’s affirming that the work we are doing is the work of the angels,” Williams said. “It’s been the most rewarding experience that I’ve ever had, but it’s also the most heart wrenching.”
Williams said he never thought he would be where he is today.
“When I became mayor, I never imagined this would be what I’m dealing with," Williams said. "This isn’t my forte. This isn’t my background.
“The beauty of it is if you lead and it’s shown in the proper direction, individuals line up to support. We have a loving, caring, compassionate community, state and nation. That’s where that little ray of hope is for me.”
Williams said the community is not done.
“You will never hear me say mission accomplished," he said. "There’s still so much to do."
He said he isn't looking for someone to come in and tell him what to do. He said he is looking for a partner.
“What Cabell County has done is beyond measure,” Williams said. “I’m not looking for a money grab. I’m looking for the capacity that my community can heal. I believe we are demonstrating we are in that direction, but the truth is addiction is highly fragile.”
Williams said there needs to be a resolution to the epidemic. He said a system needs set to see resources can do just that. He said it needs to focus on the opioid epidemic.
“We fight it every day,” Williams said. “My biggest fear is what happens if we can’t take care of this? Are we in a perpetual cycle.“
Attorney Steve Ruby, representing Cardinal Health, led the cross-examination.
Ruby questioned Williams on his knowledge of how opioids get to pharmacies, the purpose of opioids and his belief that most doctors are prescribing appropriately – all of which Williams agreed.
“While prescriptions are being written by physicians, filled by pharmacists … through this system causes me to have concern,” Williams said. “This is not my area of expertise, but it appears to me if there is a trend of high-level prescription being ordered into a community, I would think red flags and bells would be going off everywhere.
"My concern is how did you get here.”
Ruby presented a complaint filed by the City of Huntington alleging that Purdue Pharma and the Sackler family had a “corporate business plan to promote opioids to benefit the family monetarily” by using “deceptive training if the manufacturers cause prescribing of opioids to skyrocket” with other manufacturers following suit.
The City of Huntington has also filed a lawsuit against the Joint Commission on Accreditation of Healthcare Organization.
A press release was presented with a quote from Williams saying the organization “operated in concert with opioid producers to establish pain management guidelines that feature the use of opioids virtually without restriction.”
Ruby presented an email thread that included Williams, Dr. Joseph Werthammer, Dr. Joseph Shapiro and Kenny Burner – director of Appalachia High Intensity Drug Trafficking Agency – with the subject line reading “how big pharma got people hooked on opioids.”
“Unfortunately, it was not big pharma that wrote the prescriptions. It was me and my colleagues,” Werthammer wrote.
“We had some help, pain as the fifth vital sign comes to mind,” Shapiro wrote.
“Dr. Shapiro, I couldn’t agree with you more,” Burner wrote.
Ruby also presented an email Bryan Chambers, Huntington’s communications director, forwarded to Williams from Jessica Glenza, reporter with The Guardian.
The email references a call with Glenza and how she informed Chambers of a study being released that said Cabell County had the highest per capita marketing with $49.94 made to the doctor in Cabell County and the national average was $1.47 to the doctor.
Ruby continued to point out none of the defendants were mentioned in the documents presented.
Ruby dissected Huntington’s budget to clarify if the city does not spend any general fund budget on opioid treatment and that the city is in the healthiest it has ever been financially.
“We have grants to address the opioid specifically,” Williams said. “We don’t have the expertise in that. We assist entities to get grants.
"I won’t ever expect the city government to start running treatment programs or funding treatment programs.”
Ruby pressed Williams on the city not trying to restrict prescription opioids and the declaration of opioids as a public nuisance.
“I think that’s beyond the bounds of our authority,” Williams said. “One thing is quite clear; they tell us what we cannot do. [From my experience] If something isn’t explicably stated, you stay away from it.”
Ruby pressed Williams on various things, including programs, program funding, epidemic number, that have been testified to several times.
Ruby’s questions were met with several objections including a “thin ice” warning from U.S. District Judge David Faber.
Trial will resume with motions on July 1, with each side being allowed two and a half hours each.
Huntington is represented by Anne Kearse, Joseph Rice, Linda Singer and David Ackerman of Motley Rice and Rusty Webb of Webb Law Centre. Cabell County is represented by Paul Farrell Jr. of Farrell Law, Anthony Majestro of Powell & Majestro and Michael Woelfel of Woelfel & Woelfel.
AmerisourceBergen is represented by Gretchen Callas of Jackson Kelly and Robert Nicholas and Shannon McClure of Reed Smith. Cardinal Health is represented by Enu Mainigi, F. Lane Heard III and Ashley Hardin of Williams & Connolly. McKesson is represented by Mark Lynch, Christian Pistilli, Laura Wu and Megan Crowley of Covington & Burling.
U.S. District Court for the Southern District of West Virginia case numbers 3:17-cv-01362 (Huntington) and 3:17-cv-01665 (Cabell)
