CHARLESTON — The estimated price tag on the harm caused by prescription opioids in Cabell County and the Huntington community is more than $3 billion, according to a Harvard University health economist who testified Thursday in the federal trial against the prescription drug wholesalers accused of fueling the opioid epidemic.
Thomas McGuire, professor of health economics at Harvard Medical School, presented an economic valuation of roughly $3.3 billion attributed to the harm caused by prescription opioids in Cabell County and the Huntington community. Approximately $2.8 billion of that total is attributed to lives lost, while the remainder is tied to excess health care costs in Cabell County.
McGuire’s testimony opened day 29 of the opioid trial at the Robert C. Byrd U.S. Courthouse in Charleston.
Cabell County and Huntington allege that the “Big Three” drug wholesalers — AmerisourceBergen, Cardinal Health and McKesson — fueled the opioid crisis by sending more than 127 million opioid doses into the region from 2006 to 2014, before a reduction in shipped pills prompted people to turn to illegal drugs.
The drug wholesalers say it is the poor health of the state’s residents, doctors and the U.S. Drug Enforcement Administration that are to blame.
McGuire’s valuations were based on data presented earlier in the week by Katherine Keyes, associate professor of epidemiology at Columbia University, in which she calculated 497 total deaths in the area from 2006-18 that were due to prescription opioids. McGuire used a form of methodology developed from that of the federal Council of Economic Advisers to generate the financial values.
Cross-examination by Ashley Hardin, attorney for Cardinal Health, centered around finding the line between prescription opioids obtained through the actions of Cardinal Health, McKesson and AmerisourceBergen versus prescription opioids obtained illegally.
Hardin asserted that it would be a challenge to find such a line, thus making it difficult to assign blame.
“I could give it some thought,” McGuire responded, “but I don’t have that number right now.”
At the conclusion of McGuire’s testimony, Hardin and McKesson attorney Paul Schmidt attempted to strike it from the record.
“(McGuire) did not calculate the harms attributable to our conduct,” Hardin told Senior U.S. District Judge David A. Faber.
“We are attempting to put before the court an objective measure of how much of an unreasonable interference it is,” responded the plaintiffs.
Faber said he would think on the request before making a decision.
Also providing expert testimony was Dr. Judith Feinberg, vice chairwoman for research and professor of infectious diseases at the West Virginia University School of Medicine.
Feinberg spoke on what she called a series of “syndemics” that are part of the “complex public health crisis” currently facing West Virginia, placing an emphasis on the transmission of HIV and other bloodborne illnesses.
Feinberg leaned on incorporating data into her testimony, focusing on the increase in diagnoses of illnesses such as HIV in southern West Virginia. In 2019, Feinberg noted, there were 69 diagnosed cases of HIV in Cabell County, representing a growth of 52 from the year prior. Sixty-three of those cases were found in people who inject drugs.
When asked, she agreed that the intake of opioids across the state was a direct factor to the aforementioned public health crisis.
“There’s no question in my mind that these two are related,” Feinberg said.
Skip Holbrook, the former chief of the Huntington Police Department, was the final person called to testify Thursday. He said dealing with prescription pills and opioids was a significant issue on the department’s radar when he became the chief in 2007.
“There was an outrageously strong demand for drugs in Huntington,” Holbrook said. “We had an addicted population, unfortunately.”
Attorneys for the defense raised concern with parts of his testimony, saying that it was inconsistent with his prior deposition. Specifically, an objection had been raised when Holbrook identified a Huntington pharmacy that was under investigation, which the defense said he had not mentioned previously. Faber said he would review the testimony.
Holbrook later appeared visibly distraught when he was asked about the opioid epidemic’s impact on Huntington, which is also his hometown.
“When I became police chief, it was evident that this was not the city I grew up in,” Holbrook said, later adding, “It had a lasting impact on me, personally and professionally.”
Holbrook was the final witness to be called this week. Following a break, the trial will resume June 28.