The morgue of the county of Summit, north of Ohio, it is a thermometer of the crisis of opioid that is rocking the united States. When the fentanyl, a synthetic opioid 50 times more potent than heroin, is infiltrated in the streets in 2017, the forensic scientists were the first to notice. They came in bodies intoxicated at a pace unknown to the county half a million of inhabitants: up to a dozen per weekend. On at least five occasions they were forced to request refrigerated trucks to preserve the corpses. The rate of deaths in the State is 39.2 per 100,000 people, when the national average is 14.6, according to the latest data available.

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Marie Burger-Rutter, 39 years old, was a sigh of being part of the statistics. The August 23, 2018 bought with her boyfriend $ 100 in heroin. It is injected into a chest, to not leave traces in his arms, and fell unconscious. The paramedics reported three breaths per minute. Like many consumers, the dealer (the dealer) did not give him what he asked, but fentanyl, which is responsible for 70% of the drug overdose that year.

When Marie, who remains sober from the overdose, he began to buy opioids in 2006, a pill of Vicodin cost a dollar. “Opioids were everywhere and were easy to access, until 2011, when it uncovered the increase in prescriptions,” he explains in a rehabilitation center of Akron, the major city of the county of Summit, where he works advising drug addicts while doing their treatment. Effectively, pharmaceutical companies and the distributors were responsible for the opioid to reach all corners of the country. Between 2006 and 2012, pharmacies received 76.000 million pills of oxycodone and hydrocodone, doubling the amount in six years, according to a research revealed in July by the Drug enforcement Administration (DEA, for its acronym in English). The county of Charleston, in South Carolina, received an amount enough for each inhabitant to count with 248 pills of the year.

The scandal that resulted in the increase of opioid prescription —many of the addicts started to take to relieve the symptoms of physical ailments—, pushed the local governments to sue the pharmaceutical industry for misleading the marketing of the opioid, while minimizing its risks addictive, and distributors, for not detecting the danger, when it is one of their responsibilities. The nearly 2,500 lawsuits ask for compensation estimated at 50,000 million dollars. However, despite the pressures exerted during the last week by the judge, plaintiffs and defendants have failed to be understood. In the last two decades, there have been about 400,000 deaths due to this cause.

Jonathan, addicted to opioids, in a rehabilitation center, Oriana House, Akron. A. L.

The slowdown to the pharmaceutical in 2011, it was too late. Jonathan, white, 34 years old, is addicted to the oxycodone (60 dollars per pill on the street) and to the methamphetamine. Began to consume opioids in the university when it became into something “socially accepted”. This epidemic “has passed the socio-economic levels; it was not only the drug hitting the african-american poor, struck us all,” he admits in a rehabilitation center, while serving probation for possession of illicit drugs.

When the oxycodone has disappeared from the black market, Jonathan, who was already engaged at the level of consuming three pills daily, he sought to relieve their pain with heroin. Purdue Pharma, the manufacturer of OxyContin (a brand of oxycodone) was declared in September in bankruptcy to resolve the thousands of lawsuits against you. The amount of the compensation is around 10,000 million dollars ($9.025 million euros), which will be allocated to the fight against the health emergency is declared.

Marie came to consume four tablets per day, at $ 40 each (about 36 euros). Tried everything and lost it all. Including custody of their four children. “People are willing to pay a lot of money for pills because the heroin [that is much cheaper and it is a very wrong view] is the drug of the yonquis dirty of the street and nobody wants to be an addict”.

The problem, according to his own experience, is that when there is no longer money, it’s just in heroin, where it hides the fentanyl. “90% of addicts who accompany you in your phase of detoxification, he began hitching a ride to the opioids with a medical prescription. This is the main gate,” he warns in an old church converted into a café, where he advises his “clients” and where he has his office whose walls are grounded with diplomas of goals met of sobriety, which he has achieved in the last 14 months, and courses to become a counselor.

“The doctors have much to be ashamed of. Not everything is his fault, but at some point should have realized that opioids were addictive. Drug manufacturers and distributors were told not to, but they would have changed their practices,” remarks Bernie Rochford, vice president of Oriana House, an agency that attends to 1,000 addicts in Summit county, three-fourths derived from the courts of justice. Jonathan, that is one of them, believe that the economic agreements are insufficient. “I ruined your life and I’m not going to get anything. No one in my family had been in prison, but had a history of addictions. I went to the cocktail bar perfect of the pharmaceutical”, regrets out of the common room, like that of a prison. Oriana House is financed with government money, so indirectly, Jonathan himself is benefited with the covenants.

Ohio has changed since it touched bottom in 2017, become the second State with the highest rate of overdose deaths. One of the first steps I took was to apply the “law of the good samaritan”. People dared not to call 911 to alert of an overdose for fear that he be arrested for unlawful possession of drugs, something that cannot occur. The State also turned head to encourage the use of Narcan, a nasal spray that is administered in case of overdose to block the effect of opiates on the body for a period of between 30 and 90 minutes, after which the person should be seen by a doctor.

Not only the pharmacies decided to offer Narcan without a prescription, but that several institutes, restaurants, hotels and even service stations have it. The overdose deaths in Summit county fell from 310 in 2016 to 105 in 2018. Public health centers distributed free of charge under the Project DAWN. Also give a detector of fentanyl. “Addicts come for him because if you mixed the drug they buy at the street with water and use this test, can identify the opioid. Some want to avoid, but others, it is also what they are looking for,” explains Angela Kaiser, coordinator of the program.

The trial that was going to make history

last Monday, the Summit county and the Cuyahoga —two areas that are virtually lost in the map when they left to form part of the industrial belt— caught the attention of the whole country. The demands of both against several pharmaceutical distributors and were going to give the first judgment by opioids in a federal court in the united States. However, an hour before starting out, five of the six companies accused (pharmaceutical, Teva Pharmaceuticals, distributors McKesson, Cardinal Health and AmerisourceBergen, and the pharmacy Henry Schein Medical) reached an agreement for 260 million dollars to compensate counties. The only company that abstained was Walgreens, the chain of retail pharmacies, which will have a trial at a date yet to be defined.

as they neared the trial date, several companies sued agreed out of court with the counties, as the conglomerate Johnson & Johnson, which promised to compensate them with 20.4 million (18.4 million euros).

The federal judge Dan Polster, in charge of the macrocausa, tried to agree a global clearing that would allow ditching the nearly 2,500 lawsuits at the national level at one time. Did not want to give way to the first federal trial because he knew that was the beginning of a string of lawsuits that will surely take years to resolve. Until now, only the judgment of Ohio had a date, so that it served as a measure of pressure. However, the 50,000 million dollars (more than 45,000 million euros) of compensation sought Polster were not well received and the broad agreement to resolve all claims, as happened with the tobacco industry, is still in discussion.

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