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Cherokee Nation is suing CVS Health, Walgreens, and other drug companies and retailers, alleging the companies didn’t do enough to stop prescription painkillers from flooding the tribal community and creating a crisis of opioid addiction.

The lawsuit, filed in tribal court on Thursday, alleges that the companies failed to properly monitor opioid prescriptions and orders. The tribal government alleges that those patterns should have raised red flags that the companies are legally responsible for reporting to federal officials.

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“These drug wholesalers and retailers have profited greatly by allowing the Cherokee Nation to become flooded with prescription opioids,” the lawsuit alleges. “They have habitually turned a blind eye to known or knowable problems in their own supply chains.”

The rate of drug-related deaths among American Indian and Alaska Native people has nearly quadrupled since 1999, according to the Indian Health Service. It’s now double the rate in the US as a whole. Oklahoma — home to most of the 120,000 citizens of Cherokee Nation — leads the country in prescription painkiller abuse.

Cities and counties across the US have filed similar lawsuits against drug companies. West Virginia included several pharmacy chains as well in a case brought against opioid distributors. But this is the first case brought by a tribal nation seeking to hold those dispensing prescriptions responsible for an epidemic of opioid addiction.

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In a statement to STAT, CVS Health said it has “stringent policies, procedures and tools to ensure that our pharmacists properly exercise their corresponding responsibility to determine whether a controlled substance prescription was issued for a legitimate medical purpose before filling it.”

Walgreens declined to speak on pending litigation.

Under the Controlled Substances Act, pharmacies and drug distributors are legally responsible to flag federal officials when they see suspicious orders or prescriptions for controlled substances such as opioids.

Those suspicious orders can take several forms. They could involve patients filling multiple opioid prescriptions from different doctors — known as “doctor shopping” — or an order for opioids that’s disproportionately large for the local population.

“Pharmacists have a duty only to fill scripts that are for a legitimate medical purpose,” said Richard Fields, a D.C.-based lawyer who filed the lawsuit on behalf of the tribe. “If a doctor is engaged in prescribing opioids illegally, that doesn’t relieve the pharmacy of liability.”

In 2015, an estimated 845 million milligrams of opioids were distributed in the 14 counties that span Cherokee Nation, according to the Drug Enforcement Agency. That averages out to between 360 and 720 pills per year for every prescription opioid user in the Cherokee Nation, the lawsuit says.

By 12th grade, nearly 13 percent of American Indian teens have used OxyContin, according to the American Drug and Alcohol Survey. And 2.6 percent of American Indian students in 12th grade have used heroin, nearly double the rate of the general population.

“As we fight this epidemic in our hospitals, our schools, and our Cherokee homes, we will also use our legal system to make sure the companies, who put profits over people while our society is crippled by this epidemic, are held responsible for their actions,” Cherokee Nation Principal Chief Bill John Baker said in a statement.

There have been a slew of lawsuits filed by local governments accusing drug makers of contributing to the opioid epidemic by downplaying the addictive properties of painkillers and improperly encouraging doctors to prescribe the drugs.

In February, for instance, Erie County, N.Y., sued four companies — Purdue Pharma, Johnson & Johnson’s Janssen unit, Teva Pharmaceuticals, and Endo International — for costing the county government millions of dollars each year to fight the opioid crisis.

“The goal is to get justice for the Cherokee Nation and to recover the extraordinary losses they’ve suffered as a result of the opioid epidemic,” said Fields.

Correction: A previous version of this story incorrectly asserted that Cherokee Nation’s suit was the first in the US to target pharmacies.

  • I hope the whole case gets thrown out! It’s always someone else’s fault. I’ve known for years that these medications have a risk of habitual use. It’s stated right on the bottle and with the pamphlet that accompanies your prescription. Try reading you morons. The only people hurt by all this crap are patients, who now have to suffer because of the people with no self control, thanks losers, Lance.

  • Just this month my prescription for hydrocodon was reduced to three pills a day. I have had chronic pain syndrome for years because of serious injuries suffered in an automobile accident. I am now 78 years old and have and have used this medicine for years. The one pill a day they have reduced will really affect my pain control and because of this, my depression has increased significantly already. What am I to do?

    • I am very sorry to hear this. Ask the medical provider why the dose was reduced.
      There must be a reason.
      Also, try to find a new provider who is more sympathetic to your pain.
      Not all doctors are the same.
      Take someone with you to every appointment!

  • There is no crisis, fake news. Government going after little old ladies medicines and chronic intractible pain patients who can not fight back insteajavascript:history.back()d of the real issues, cartel heroin supply and chinese fentanyl supply easily available for drug dealers.

    • This is a Pharmacy issue because the Pharmacies are making it one.
      Big Corporate Pharmacies like CVS are trying to be gate keepers.
      They are trying to control who gets their medication, and when.
      Even if the patient has a valid prescription!

  • Definately a very valid concern. However, let’s be careful in our desire to better “control” this rightful concern not to create undue issues for those patients who are on these meds for VALID reasons, especially when surgery is not an option for them, lest we also increase the suicide rate of those who are denied their pain medications & end up taking their own lives because their pain is unbearable without them. Issues of suspicious prescribing should be carefully investigated to avoid “witch hunts” & treating patients like their pain is less than what is considered “normal for the masses.” The physicians treating these patients know their patients histories/backgrounds & should be permitted to treat their patients accordingly, unless there is obvious negligence & confirmed danger to the patient.

    • I would like to say thank you for a great comment . Being a Cherokee citizen , living with chronic pain , now facing real serious health issues. I went to Dr mind you a Cherokee Nation clinic today,went over a ER visit follow up and continuing care plan when we talked about pain control the Dr stated he could not prescribe me the meds I was sent home on because ” The Cherokee Nation has a law suit against the company’s and pharmacy that make and fill the drugs ” yes this was Dr statement to me , and that was it . My case is I have chronic pain and now a illness that leaves me no other option I have taken all other avenues . Chronic pain clinics six weeks inpatient MN the best program in the US no pain meds and I refused them ,used non medication alternative for two years. I am a educated person health care mind you . Lived 33 years of my adult life in MN . You are right if Dr are not treating there patients because of this law suit I fell that is a derelict of their duty as a physician all for a law suit and profit to the nation .
      Respectfully, Wado
      Cherokee Nation Member…

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