THE BURNED OVER DISTRICT

And since they have been getting away with murder for a long time, it is long overdue for the decision making executives at the makers of opioids to receive their just punishment.

Steve Williams, mayor of Huntington, a city ravaged by prescription pill and heroin addiction, said he wants to see executives face criminal prosecution, after it was revealed that a member of the family that made billions of dollars from the painkiller that unleashed the epidemic stands to profit further after he was granted a patent for an anti-addiction medicine.

“They are drug dealers in Armani suits,” said Williams. “You have the corporate executives that are the ones who make the decisions. Just because this person is working on a street corner selling drugs and this other person is working in the executive suite 50 storeys up, is there really that much of a difference? Just because you are in the executive suite doesn’t mean that you are immune from the results of the corporate decisions that you make. Just because you have billions of dollars at your disposal doesn’t mean that you shouldn’t be held accountable. The decisions that have been made within the pharmaceutical industry have ravaged our nation.”

Activists have backed Williams’ call amid an increasing focus on the role of drug company executives in pushing opioid painkillers as the pharmaceutical industry fights off a flood of lawsuits over an epidemic estimated to have claimed at least 350,000 lives.

In June, Massachusetts became the first state to sue individual executives and owners of Purdue Pharma, the maker of the drug, OxyContin, which kicked off the biggest drug epidemic in American history, estimated to be killing more than 115 people a day. The lawsuit seeks to recover the billions of dollars in profit banked by members of the Sackler family, which owns Purdue and is divided between the US and the UK.

Massachusetts attorney general Maura Healey, accused the company and its officials of knowingly profiting from overdoses and death.

“Purdue Pharma and its executives built a multi-billion-dollar business based on deception and addiction. The more drugs they sold, the more money they made, and the more people in Massachusetts suffered and died,” she said in announcing the lawsuit.

Purdue has vigorously rejected the accusations but the Massachusetts case is only one of more than a thousand against the firm and part of a wave of actions against opioid makers, distributors and pharmacies that some lawyers predict will result in a total settlement that dwarfs the $246bn paid out by tobacco companies over smoking deaths.

Williams was among the first mayors to pursue the drug companies. West Virginia has the highest drug overdose rate in the US. Huntington is capital of the county with the largest number of opioid deaths in the state although it has brought the toll of addiction down sharply over the past year.

Williams wants to see a substantial settlement agreed swiftly to help fund programs to deal with the consequences of the epidemic, such as residential addiction treatment and care of children orphaned by drug overdoses. But he is not alone in believing that the crisis spread unchecked for years in part because big corporations were allowed to pay fines or civil penalties when they broke the law and then carry on as before. The mayor questions whether civil suits alone are sufficient to call those responsible to account and to discourage what he regards as a lethal disregard for the law.

“I can guarantee you this, that if an executive all of a sudden knew that they were going to be hearing iron doors closing behind them that would immediately send a ripple throughout all of the corporate boardrooms. All it takes is one public execution,” he said.

That may come in the form of a pending prosecution against the billionaire founder and CEO of the drug-maker Insys Theraputics, John Kapoor, on racketeering, conspiracy and corruption charges. Kapoor has denied allegations of bribing doctors to prescribe a powerful and highly addictive opioid approved for cancer patients, Subsys, for people who did not have the disease. An Inysys sales manager has already pleaded guilty to paying kickbacks to doctors to prescribe Subsys and in August the company paid $150m to settle the justice department investigation into its practices.

But critics of the industry say Insys was a latecomer to profiting from the epidemic, opportunistically seizing on the chance to sell more drugs only in recent years. They point to Purdue and other firms pursuing a much longer strategy of misrepresenting and promoting opioid painkillers, including using political lobbying and well-funded front organisations to influence medical policy, and then resisting efforts to reduce mass prescribing even as the death toll rose in order to preserve profits.

Williams’ call for criminal penalties also comes amid growing anger at attempts by the drug-makers to defend themselves from lawsuits by blaming the victims of addiction and the doctors who prescribed the pills. Purdue is conducting a public relations campaign to portray itself as committed to combatting the epidemic. In newspaper adverts the company claims to be a “partner” in the fight against opioid addiction.

“We manufacture prescription opioids. How could we not help fight the prescription and illicit opioid abuse crisis?” it pleads.

But in court, Purdue is pursuing a legal strategy of blaming the “abusers” and their doctors not OxyContin or the manner in which it was sold.

“The alleged nuisance in this case is not caused by Purdue’s sale of its legal, FDA-regulated medications, but rather by doctors who wrote improper prescriptions and/or by third parties who caused persons without valid and medically necessary prescriptions to get opioid medications or illegal street drugs. Purdue has no control over those persons,” the company said in a legal defence against a lawsuit by the state of Tennessee.

Purdue has saturated the market with their product in part because it was marketed as far less harmful than it actually is. And its highly addictive propety means the users need for it does not end with the final pill in the prescription. And all along Purdue has been willing to provide the product whether through legal or less than legal channels. Hiding behind corporate protections, with an array of high priced lawyers and well paid politicians to man the battlements, it will be hard to bring justice to these perps.