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Last year, the city of Chicago accused the makers of high-powered painkillers of deceptive marketing, saying they overstated the benefits of their opioid meds and downplayed the risks of addiction and overdose. Five companies were initially named as plaintiffs in the suit. including Purdue Pharma, Teva, Johnson and Johnson, Actavis and Endo International. The city claimed the drugmakers misled physicians about the benefits and risks of prescription opioid painkillers, leading to a wave of addiction issues.

The deceptive marketing practices have caused health problems in Chicago, the city alleged in a news release, stating that opioid misuse resulted in 1,080 emergency room visits in Chicago in 2009. The city seeks to end deceptive marketing practices and seeks punitive damages. The city claims that the City’s Health Insurance plan “has reimbursed claims for approximately $9.5 million on these drugs since 2008.”

In the 122-page complaint filed in Cook County Circuit Court, the city of Chicago argues that the shift in medical use of opioid painkillers was the direct result of deliberately misleading marketing from pharmaceutical companies. According to the complaint, “in 2010, 254 million prescriptions for opioids were filled in the U.S.” It also reports that “20 percent of doctors visits resulted in the prescription of an opioid.” According to the press release, this accounted for a quadrupling of sales for these drugs from 1999 to 2010.

The complaint argues that the five companies named in the suit created a huge market ($8 billion in revenues in 2010) for these drugs by telling doctors (incorrectly) that they were effective for chronic pain management, which now accounts for roughly 87% of the opioid prescriptions given out in this country.

Chicago’s lawsuit has implications far beyond the city limits. If the allegations are true, they get at one root cause of the growing rates of addiction and death from opioid painkillers and heroin in the United States. Drug overdose deaths, the majority of which are caused by prescription painkillers, have more tripled since 1990, according to the CDC, and in 2010, prescription opioid painkillers caused 16,651 overdose deaths in the U.S. The implications would no doubt have an effect on workers’ compensation claim costs.

But, all of the defendants, with the exception of Purdue, were dismissed from the lawsuit this month. However, Chicago has the opportunity to file an amended suit in the next 30 days. Purdue Pharma–which makes perhaps the most notorious of the opioid pills, OxyContin–will have to fight some of the city’s accusations, under the ruling.

The claims point broadly to an alleged lack of honesty around opioid-related risks, with some specific claims related to paying key opinion leaders as speakers to support opioid use, funding advocacy groups who support the drugmakers and using persuasive tactics with physicians.

The movement against opioid use and against drugmakers has continued to grow, with advocacy groups, such as Physicians for Responsible Opioid Prescribing, calling for tighter restrictions on opioid use.

In 2007, Purdue and several top-level company executives pleaded guilty to a federal charge of misbranding Oxycontin, resulting in a fine of $634.5 million. Purdue is once again on the stand for its activities—but it stands by its commitment to provide pain relief for the hundreds of thousands of people who face chronic pain every day of their lives.