CLEVELAND (WJW) – Attorneys representing two Ohio counties along with the pharmacy chains CVS, Walgreens, Giant Eagle and Walmart have started arguing in what is expected to be a landmark case over the abuse of prescription opiates.

In a two and a half hour opening statement on Monday, Texas Attorney Mark Lanier told jurors he believes the evidence will show that pharmaceutical companies, several of them acting as their own distributors, had a legal requirement to monitor and report unusual prescriptions for powerful opiates, including oxycodone and hydrocodone.

He used the case of a customer who might be filling the same prescription from three different doctors as an example of “doctor shopping.”

Lanier said he expects the evidence to show that the companies had a legal obligation to maintain controls that would prevent those opiates from getting into the hands of those for whom they were not prescribed, but failed to give their front line pharmacists the tools to do that.

Among the red flags, he suggested, should have been suspicious shipments. Distributors, he told the jury, are supposed to be monitoring how many pills are being shipped to stores and how often.  

Suspicious orders in a suspicious or unusual pattern, including the frequency of those orders, should have been reported to the FDA and prescriptions or shipments withheld, he said.

Lanier also suggested that during the trial, documents would show that some of the companies knew there was a problem and that opioids were flowing into states, including Ohio, from pill mills as far away as Florida.

During his opening statements, Lanier said the companies had little incentive to take extra time to question suspicious prescriptions, motivated by getting the prescriptions filled quickly while the customer was still in the store and could be shopping for other items while waiting for their pills.

The lawsuit alleges that the resulting opioid crisis cost Lake and Trumbull counties billions.

Judge Dan Aaron Polster instructed the jury that during the trial, attorneys for the two counties would have to show the companies were negligent or failed to follow the law in contributing to a public crisis.

Lanier told jurors in his opening statements that the controls did come slowly, but by the time the pharmacies did catch up and start creating systems and policies to deal with the epidemic, it was too little too late. He said those whose prescriptions were cut off were taking their addictions to the streets to find illegal sources of the drugs, including heroin.

The trial is expected to take six to seven weeks with attorneys for the pharmacies expected to argue that all they did was fill legal prescriptions and they cannot be held responsible for addictions.