It was the first time that New Jersey has brought legal action against a company based in the state as it struggles to contain a spiraling opioid addiction crisis. And it comes at a time when state attorneys general across the country have intensified their efforts to hold pharmaceutical companies accountable for the epidemics of abuse.
Gurbir Grewal, the New Jersey attorney general, said the subsidiary, Janssen Pharmaceuticals, minimized the risks of opioid addiction in its marketing messages, targeted older people and other patients with little knowledge of opioids and mounted a campaign to “embed its deceptions about the viability of long-term opioid use in the minds of doctors and patients.”
“It is especially troubling that so much of the alleged misconduct took place right here in our own backyard,” Mr. Grewal said at a news conference announcing the legal action. “New Jersey’s pharmaceutical industry is the envy of the world, with a long history of developing vital, lifesaving drugs. But we cannot turn a blind eye when a New Jersey company like Janssen violates our laws and threatens the lives of our residents.”
A representative for Janssen did not immediately respond to requests for comment.
In the absence of any significant federal action to stem the opioid epidemic, states have been leading the charge to grapple with a health crisis that has yet to be contained. In 2017, there were more than 72,000 overdose deaths in the country from opioids, a 10 percent rise from the previous year.
More than 40 state attorneys general have joined New York state in a multiyear, wide-ranging investigation of manufacturers and distributors of opioids. Eleven states, including New Jersey, have filed separate lawsuits against Purdue Pharma, the manufacturer of OxyContin, a popular opioid painkiller.
“It became a state issue because there wasn’t a lot of movement on the federal level,” said Lewis S. Nelson, the chairman of the Department of Emergency Medicine at Rutgers University. “To this date, the federal government hasn’t been very effective at regulating the practices of these pharmaceutical companies.”
In addition to the human toll, the opioid crisis has also imposed a significant financial burden that has been largely shouldered by states, Dr. Nelson said, including paying for hospital bills, drug courts and emergency response.
In New Jersey, the state also pays for opioids through public employee health plans, according to the lawsuit. New Jersey spent $178 million between 2010 and 2017 for opioid prescriptions submitted to employee health plans, according to the attorney general’s office.
While there have been some positive trends in the opioid epidemics at the national level, including a drop in the number of overdose deaths in parts of New England, New Jersey’s death rate has been rising steadily. Nearly 2,700 overdose deaths have been confirmed in the first 10 months of this year, according to data collected by the state attorney general’s office. In 2017, preliminary data show that there were 2,750 overdose-related deaths.
The opioid crisis in New Jersey became the main focus of Gov. Chris Christie’s final year in office and he used his national platform as a presidential candidate to repeatedly call for reforms on treating opioid addiction and prosecuting drug abusers. President Trump also named Mr. Christie as chairman of his commission on the opioid crisis. Besides suing Purdue Pharma, the Christie administration also sued Insys Therapeutics, an Arizona-based opioid manufacturer.
But the lawsuit announced by Mr. Grewal represents a new front in New Jersey’s battle against the scourge of opioids, targeting a company that plays a key role in the state’s economy.
New Jersey has a deep and lucrative connection with the pharmaceutical and biotechnology industries. Often referred to as “The Medicine Chest of the World,” New Jersey was once home to many major pharmaceutical manufacturers, such as Pfizer, Merck and Johnson and Johnson. And while some companies have left the state, the industry still accounts for roughly 120,000 jobs, totaling $16.5 billion in annual payroll in 2016, or 7.8 percent of the state’s total wages.
Mr. Grewal told reporters that his office was not investigating Janssen’s parent company, Johnson & Johnson, but said that additional charges could be filed. Though Janssen is one of the state’s largest employers, Mr. Grewal said that did not factor into his office’s decision making.
“We’re not shying away from holding folks accountable,” Mr. Grewal said. “If they’re culpable, we’ll hold them accountable.”
The lawsuit is similar to other lawsuits against pharmaceutical companies, tracing the evolution of opioids from short-dosage painkillers in the early 1990s to drugs whose effects are more long term.
“Janssen joined the wave of opioid manufacturers working to persuade health care providers and patients — including the elderly and opioid-naïve — that pain had been widely and improperly under-treated, and that opioid pain medications were the answer,” the lawsuit says.
Mr. Grewal stood beside placards displaying what his office said were examples of Janssen’s fraudulent marketing campaigns for their opioid products. While Janssen sold the rights to the two drugs in 2015 for over $1 billion, Mr. Grewal said his office was focusing on the eight-year period that the company marketed the drugs.
“They funded bogus research,” he said. “They pushed bogus theories like pseudoaddiction, things that have been debunked. They positioned Nucynta and Nucynta ER as the safer alternative to other more powerful opioid drugs and, as the director mentioned, in fact, they were the same types of opioid drugs.”
The lawsuit also pointed to disturbing trends in the prescription. Over the course of a year, one patient on a state health care plan received 125 prescriptions for two opioids, Nucynta and Nucynta ER — more than a 2,700-day supply. The prescriptions were written by a health care provider “who had received hundreds of visits from Janssen sales representatives.”
The mounting legal campaigns against pharmaceutical companies, Dr. Nelson said, highlights how complicit many believe they are for the crisis.
“Everybody on opioids for more than a couple of weeks is dependent, only about five to 10 percent of people develop addiction,” he said. “But remember, five to 10 percent of millions and millions of people is a lot of people. So, that’s what the state attorneys general are really fighting against. They’re fighting against the fact that all of these companies put out marketing and misinformation that these drugs don’t cause addiction, don’t cause dependence, don’t lead to abuse.”
“In reality,” Dr. Nelson added. “Lots and lots of people died using the drugs as directed.”