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Sunday, April 28, 2024

Drug companies grill addiction science director about funding numbers, program timelines

Federal Court
Marshallu

CHARLESTON – As the landmark federal opioid trial concluded its fourth week, attorneys for Cardinal Health probed an addiction science professor from Marshall University about recovery programs and estimated costs. 

The City of Huntington and the Cabell County Commission sued three of the nation’s top pharmaceutical distribution companies – AmerisourceBergen, Cardinal Health and McKesson – in 2017 seeking compensation over claims the companies helped fuel the opioid epidemic by sending more than 81 million controlled substances to the county between 2006 and 2014. 

Before the start of testimony May 28, U.S. District Judge David Faber, who is overseeing the bench trial, brought up previously admitted documents that were not presented to the media. Faber said that while he does worry about how the media can misconstrue the documents, with a previous ruling in mind, he felt the public had the right to see the documents. 


O'Connell

“I think I’ve got to disclose this, and the media has a right to it,” Faber said. 

Attorney Paul Farrell Jr., representing Cabell County, requested that documents be presented at the end of the week instead of daily. With no objection from the defendants, Faber ruled in Farrell’s favor. 

Then, attorneys for the plaintiffs continued their examination of Lyn O’Connell, associate director of addiction sciences at Marshall Health, with questions of the plans put together to continue programs and the grants used to run each program. 

O'Connell assists with Marshall Health's and the City of Huntington's response to the substance use crisis through clinical services, grant writing, research and program development, implementation and oversight. O'Connell also works with the City of Huntington on the advisory board of the Compass Project to promote resiliency in first responders and as the primary investigator for the Huntington Quick Response Team.

O’Connell explained City of Solutions, a document that had all the community work being done combined into a single location. It was believed it could be replicated in other areas of the state and she said they did 14 presentations of the program, touching all 55 counties.  

O’Connell discussed the importance of including community experts and looking at all connections of current programs to find future needs. One of those needs being focusing on economic development. 

“If they [those in recovery] can’t make money, they will go make money in a way they had done before,” O’Connell said. 

O’Connell said the committee has put together a brief document outlining the program with the short and long-term goals – goals include more focus on sustainment and preparation for future generations. 

“The groundwork is there,” O’Connell said. “We as a community chose not to bury our head in the sand and not acknowledge our problems. [We said] how can we recover from this.”

O’Connell testified that all of Cabell County’s programs currently are funded by grants. She said that is a difficult process that took legislative efforts and reconfiguring to make possible. O’Connell said Huntington previously would be turned down for needed grants that were rewarded to large cities with numbers much smaller than Huntington and Cabell County. 

She said grants received by Cabell County and Huntington go directly to support and expand current programs and future needs. O’Connell said the support need never ends. With substance abuse disorder impacting families and causing children to be removed from homes, she said the need for kinship and foster care support is a high need. 

O’Connell said the programs connect in different ways and that one issue can show more issues that need addressed. 

“There’s a lot the community needs as we move forward, we want to be flexible,” O’Connell said. 

O’Connell gave an example of a transportation being a large barrier to recovery. She said having those in recovery who live 10 miles outside of town can make it difficult for them to get to treatments or to meetings. She said this leaves a large need – 24/7 help, mobile clinics, expanding resources into rural efforts – to sustain harm reduction and harm reduction efforts. 

“You can’t address one issue without addressing the others,” O’Connell said. “All programs [are] interconnected in some way.”

O’Connell said the process of grant writing can be not only tedious and strenuous, but grants can be rejected for simple, small mistakes. She said grant cycles change and it is never known what money will be available to request. 

Plaintiffs asked O’Connell what it would mean to the community to have “long-term, sustainable [and] reliable funding.”

“I can’t even imagine what all could be done,” O’Connell said. 

Cross-examination was led by Steve Ruby representing Cardinal Health. 

He mentioned a recent radio interview, asking O’Connell about a response she gave during the interview about the trial and the possibility of “millions of dollars” coming into the community. 

“I was asked what I believe a settlement could do, and I responded,” O’Connell said 

Ruby presented emails from Steven Petrany, chairman of Marshall University’s Department of Family Community and Health. The email discussed a meeting held downtown and one that Farrell allegedly attended. 

Ruby continuously asked O’Connell if the comprehensive plan discussed in the email was planned to be used in the pending litigation and that the idea of the community have a strategic plan was discussed. 

“When in that initial meeting, it was not my awareness the plan was something that was going to be use in future litigation,” O’Connell said. “I knew that we were creating a strategic plan to move the community forward.”

O’Connell said she knew a strategic plan for the community was being formed and that it could be utilized in anyway by anyone, stating that she assumed it would likely be used as “we were putting together a plan [to improve community]."

Ruby presented several drafts of the resiliency plan questioning the numbers for estimated funding and O’Connell’s knowledge of a meeting involving Farrell, arguing changes could have been made in result of the meeting. 

“I recall countless changes to the plan,” O’Connell said. “I cannot recall what necessarily [caused] those changes.”

During the questioning, Ruby changed several phrasings of questions when O’Connell answered in certain ways, claiming he was ensuring they were on the same page. 

Cross-examination then moved to AmerisourceBergen. Its lawyers questioned O’Connell on her presentations leading to her beliefs of factors of the opioid epidemic and funding. 

A presentation of O’Connell’s was presented where it was noted, West Virginia has the highest prescribing rate of benzodiazepines (71.9/100) and the third highest prescribing rate of opioids (137.6/100). 

While O’Connell said she does believe it is a contributing factor, a slide of contributing factors to the drug epidemic that O’Connell speaks about during presentations did not show distribution centers as a contributor. 

O’Connell was questioned on knowledge of numbers ran for a plan created by Marshal University and presented to the Merck Foundation. 

Defense argued the plan had a smaller estimated budget as closing arguments. 

The trial was adjourned until June 7. 

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)

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