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County Commission Communications
A Periodic Column Written by Ed Douglas, Presiding Commissioner

AUGUST 23, 2018

Livingston County Commission to Join Lawsuit Against Opioid Manufacturers and Distributors

After consulting with our Prosecuting Attorney Adam Warren and meeting with a Kansas City Law firm that is representing a number of counties and cities near us, our Commission has decided to join a lawsuit against opioid manufacturers and distributors.

Opioid use has become an epidemic in our country with over 70,000 deaths last year; more than the combined deaths from automobile accidents and firearms. From the research we have seen, drug companies and distributors have severely over marketed opioids for chronic conditions rather than just for short- term pain. This over marketing has lead to misleading information about addiction from continued long- term use which in large part has lead to a crisis all over our country, and especially in rural areas.

Unfortunately, Livingston County has not missed this problem. The statistics show that in 2015 there were 117 prescriptions for every 100 people living in Livingston County. A prescription is considered 30 pills per month. Think about this. We had more prescriptions in the county than people living here! It is our understanding that this is one of the highest rates in the State of Missouri. I have talked to several expert people on the reasons why our county's rate would be so high, and it seems that there are several doctors in the region (not locally) who over prescribe opioid pills. Livingston County is a regional economic hub where people can get opioid prescriptions filled; then, in all two many cases, illegally resell them.

It should be noted that Livingston County was one of the first counties in North Missouri to implement a drug monitoring program at the first of the year in conjunction with the St Louis County Health Department. This program allows pharmacies in our county to monitor if a patient attempts to fill multiple prescriptions at different pharmacies. If an abuse is detected, the doctor will then be made aware of it, which can then lead to restricting the abuse. The program has already prevented many people from filling opioid prescriptions from multiple doctors who did not know about the patient's other prescriptions. This is a start, but does not by any means solve the problem.

Although every situation is different, here is an example of a how a drug problem can start. A person who becomes disabled or convinces a doctor of a disability and is eligible for Medicaid, then gets an opioid prescription for the pain. The out- of- pocket cost for this prescription is probably $10 or less, with Medicaid paying the rest. The pain continues, and the person becomes hooked, then resorts to getting the prescription renewed or finds a doctor in the area who is overly aggressive in prescribing opioids. Where the problem really escalates is that with the number of addicts there are, a single opioid pill can be resold illegally for from a few dollars to up to $83 a pill which leads to drug dealing.

By far, the largest part of crime in Livingston County is from drug related crimes. This then leads to a large jail bill for the county and untold costs to our community. And a large part of those drug related crimes are due to opioids.

In discussions with our Coroner, Scott Lindley, we have learned that approximately two years ago there were 17 deaths within one year from opioid overdoses. It should be noted that our Coroner and Prosecutor have worked together to go after doctors and/or pharmacies that appear to be abusers, whether they are in this area or not. From talking with them, they have rooted out several abusers which has slowed the trend in the last couple of years.

It is difficult to say what the results of this lawsuit will mean for the county. But it is clear that the costs to the county are large, and there certainly appears to be culpability. Although our County Commission wanted to make you aware of us filing this lawsuit, we also wanted to make you aware of the size of the problem. It will take all of us working together to help solve this abusive and costly epidemic.

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