Baltimore spent $197 million over the past 12 years on the opioid epidemic, expert says at trial

Over the past dozen years, Baltimore has spent at least $197 million — an average of more than $16 million a year — battling the raging opioid epidemic, an expert hired by the city testified in its civil suit against two drug distribution companies.

William V. Padula, a professor of pharmaceutical and health economics at the University of Southern California’s Mann School of Pharmacy and Pharmaceutical Sciences, said in court that he calculated this in part by looking at the budgets for police, fire and health care in Baltimore . departments, as well as the Mayor’s Office of Homeless Services, starting in 2011 and 2023.

Padula said he aimed “to be as conservative as possible in my estimation.” His calculations projected that these city agencies would incur more than $73 million in expenses related to the opioid epidemic between 2024 and 2029.

His testimony Tuesday afternoon came in the fourth week of a trial in Baltimore’s lawsuit against drug distributors McKesson and AmerisourceBergen, which accused the city of pumping hundreds of millions of addictive painkillers into the region between 2006 and 2019, without any regard for the havoc the companies experienced. . they were able to cause.

What Padula said in court is critical to Baltimore’s case, because the city’s lawyers are not only trying to convince the jury to hold the distributors liable for depriving Baltimoreans of their right to public health and safety, but jurors also asking for “millions and millions and millions” to be awarded. in damages to the city, as an attorney said in his opening statement in September.

While much of the testimony in the case so far has focused on what the companies did and didn’t do and the real-world impact of the epidemic on the streets of Baltimore, Padula put a dollar figure on the crisis in her accounting.

Before him, a former DEA agent discussed McKesson and AmerisourceBergen’s policies on tracking suspicious orders of opioids and provided analysis so detailed that it revealed individual shipments of pain pills to pharmacies around Baltimore. In short, the former agent said, the company ignored “red flags” that the drugs it sold were getting into the wrong hands.

A fire chief said firefighters reversed up to 6,000 opioid overdoses each year with the lifesaving drug Naloxone. A health department official described efforts to limit the epidemic’s damage with programs such as needle exchanges and mobile clinics that treat related wounds. A supervisor at the Department of Public Works spoke of drug-affected areas, littered with trash and used needles, and soiled by human feces.

Lawyers for McKesson and AmerisourceBergen have said the companies are not responsible for Baltimore’s opioid problem, instead pointing the finger at cartels, gangs and street hustlers who bring heroin and fentanyl into the city and sell them on street corners. Their questions during the trial focused primarily on illegal drugs, rather than prescription pills.

After listening to Padula, who is also a researcher at his university’s Leonard D. Schaeffer Institute for Public Policy & Government Service, jurors heard from an insider at one of the drug distributors, a former McKesson salesman in Maryland of about 40 year.

Garry Adam was called by the city and had to testify in person, rather than through a videotaped statement, because he lives out of state.

Adam testified that it was his responsibility to keep McKesson’s customers in the Baltimore area, including independent pharmacies, happy by making sure they had the products they needed to stock the shelves. Unlike with over-the-counter medications, when a pharmacy was running low on opioids or other controlled substances, Adam had to fill out a questionnaire asking for more on their behalf.

After Adam completed the questionnaire, it was up to the company’s regulatory department to approve or deny the request for more opioids. Taken together, testimony from Ruth Carter, the former DEA agent, and Adam showed that McKesson rarely refused to raise a pharmacy’s opioid threshold.

In the case of one company, Drug City Pharmacy in Dundalk, which has been described by the court as one of McKesson’s largest opioid customers nationwide, Adam made requests from the pharmacy on successive days in August 2009 to increase its supply of oxycodone. with 20,000 pills.

These requests came within a period of approximately ten months during which Drug City’s monthly oxycodone supply increased from 60,000 to 220,000 pills.

Adam often justified requests for pill increases by writing in the questionnaire: “Customer numbers are increasing at a very rapid pace.”

Carter previously testified that data she reviewed showed Drug City ordered more oxycodone than any other pharmacy in the country, describing the finding as “shocking.”

“This is just so much oxycodone,” Carter testified. “I can’t think of an explanation.”

Former Drug City owner Mark Lichtman, meanwhile, said in a statement that Adam “congratulated me for being the best oxy person for McKesson.”

Adam defended his work during his testimony, describing the pharmacy as a “very, very large prescription store.”

“Doctors,” he said, “wrote the prescriptions for oxycodone… We couldn’t tell if that prescription was good, bad, cash or credit.”