SALISBURY — Rowan County officials on Monday decided to join a national lawsuit against opioid manufacturers and distributers.

The lawsuit alleges that pharmaceutical manufacturers use false, deceptive and unfair marketing tactics to encourage opioid use.

It also alleges that distributors failed to comply with federal and state law to monitor and report suspicious prescription orders.

In closed session on Monday, the Rowan County commissioners voted to retain legal teams to file the lawsuit against manufacturers of oxycodone, hydrocodone and fentanyl.

Distributors being sued include McKesson Corp., Cardinal Health and AmerisourceBergen Drug Corp.

Rowan’s lawyers are located in Texas, Mississippi, Florida, West Virginia and North Carolina. Ed Powell, a lawyer with Melvin and Powell of Winston-Salem, will represent the county as it seeks to recover the nearly immeasurable expenses related to opioid abuse.

“The county is dealing with exploding costs, strain on financial and physical resources, and, most important, public safety,” said commissioners Chairman Greg Edds.

According to Powell, the case will require extensive data and analysis that the county does not yet have. But he said his firm has engaged outside counsel who have agreed to pay all research and analysis costs associated with the litigation.

“It’s hard to get a handle on what the total cost to our county and our citizens truly is,” said Commissioner Judy Klusman.

Adding to Edds’ comments, she said, the opioid epidemic has cost the county money in terms of law enforcement, public health, social services and more.

“Even the school district is dealing with this because there are parents that are addicts,” she said.

False, deceptive and unfair marketing

According to a similar suit filed by Buncombe County, the use of opioids for chronic pain was discouraged or prohibited before the 1990s.

Opioids do not reduce pain or improve function. Rather, they increase complaints about pain as patients develop tolerances for the drugs, the suit says.

Pharmaceutical companies have used dishonest marketing tactics to persuade doctors and patients to use opioids for chronic pain, according to the lawsuit. These companies, it says, trivialized the risks and overstated the benefits of opioid use.

The lawsuit cited an ad series run by Purdue Pharma for OxyContin that featured chronic pain patients. One ad showed a “54-year-old writer with osteoarthritis of the hands,” and it implied that the drug would help her work more effectively.

The questionable marketing practices have helped make opioids the most prescribed class of drugs, with revenues in the United States exceeding $8 billion annually since 2009, says the lawsuit.

Lack of compliance

According to federal and state law, distributors of opioids are required to monitor, detect, investigate and report suspicious orders.

Suspicious orders are those of unusual size or frequency or that deviate substantially from normal prescriptive patterns.

Rowan County attorney Jay Dees said distributors are required to report these findings to the Drug Enforcement Administration. Allegedly, he said, distributors have been advising patients to “spread out” prescriptions so the system is not alerted to abuse.

Similarly, the Buncombe County lawsuit alleges that distributors repeatedly and purposefully breached their reporting duties, potentially increasing the diversion of these drugs into the illicit market.

In Williamson, West Virginia, for example, 3,191 residents amassed 20.8 million prescription painkillers — or 6,500 per person.

“This problem was manifested by drug companies,” said Commissioner Craig Pierce. “… I think they should be the ones that are liable for the damages that they create.”

Moving forward

While retaining counsel, the commissioners also adopted a resolution during Monday’s closed session to take action to abate a newly declared public nuisance.

The nuisance was opioids, and upcoming litigation is the first step in a long road to undo damage done, according to the resolution.

Both Dees and Klusman stressed that the lawsuit will not bring cost the county. Attorneys will receive payment only in the event a settlement is awarded.

The plan is to use any settlement money to further mitigate the effects caused by opioid abuse, said board Vice Chairman Jim Greene.

“If we received any of that money, we’d use it toward rehabilitating lives that had been affected by this tragedy,” Greene said.

Pierce said this includes a possible treatment center and further education for residents.

That’s important for a problem that affects people across all socioeconomic divides, said Commissioner Mike Caskey.

“This is one of those things that can affect anybody. (There’s) no part of the population that’s immune,” Caskey said. “This is going to be a long-term deal, but this is where we need to start.”