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Austin Box was a home-grown football star at the University of Oklahoma in 2010 when back surgery to repair an injury got him started on powerful opioid painkillers that would end his life at 22, his father testified through tears on Wednesday.
A medical examiner’s report showed Box, a starting linebacker, had five prescription painkillers and an anti-anxiety drug in his system when he died, just a week after graduation. He was planning to play his final year while attending law school, his father said.
“We never suspected” that Austin had started taking opioids, Craig Box told Judge Thad Balkman in Norman, Oklahoma, where the state claims Johnson & Johnson used illegal drug-marketing campaigns and helped to create a public-health crisis.
Box was among more than 4,000 people in the state who died over the past two decades from opioid abuse, according to Oklahoma Attorney General Mike Hunter. His lawsuit — one of more than 1,900 filed by U.S. governmental bodies against opioid drugmakers and distributors — is the first of those civil cases to go to trial.
Government officials are seeking to collect billions of dollars as compensation for tax dollars spent on dealing with the fallout of drug abuse. The outcome in Oklahoma, where J&J is facing allegations under the state’s public-nuisance law, could impact claims and settlement talks involving other states, cities and counties. Balkman is hearing the case without a jury.
Box’s father, a lawyer in Enid, Oklahoma, acknowledged during his testimony that his son wasn’t taking any J&J-branded painkillers when he died. An autopsy found traces of the painkillers oxymorphone, morphine, hydrocodone, hydromorphone and oxycodone. He was also taking Pfizer Inc.’s Xanax anti-anxiety drug, according to the report.
Pfizer isn’t a defendant in the Oklahoma case. However, Hunter sued opioid makers Purdue Pharma LP and Teva Pharmaceutical Industries Ltd. for their roles in the crisis. Purdue, the top marketer in the state, settled in March for $270 million. Teva agreed on Sunday to pay $85 million, sending the company’s shares plunging almost 14% over the past two days.
J&J shares extended losses for a third day on Wednesday, falling another 5.5%, as investors pondered the drugmaker’s legal risks.
The company says it controlled a tiny share of the opioid painkiller market in Oklahoma and that it is being blamed for the bad acts of other drugmakers, including Purdue and Teva. The company also is attacking the state’s request for as much as $13 billion in reimbursement for current and future outlays to deal with societal fallout from the epidemic.
In the wake of their son’s death, Craig Box said he and his wife, Gail, formed a foundation to help educate parents about the risk of prescription opioid painkillers.
“We heard from so many parents around the country who’d also lost their child to these drugs,” he said. Gail Box has become a well-known speaker about opioid addiction in Oklahoma and was appointed to the Oklahoma Department of Mental Health and Substance Abuse Services’ board.
Also testifying on Wednesday was Russell Portenoy, a pain specialist who previously was paid to speak to doctors about opioid drugs from J&J and its Janssen unit. Portenoy said in a video deposition that he now believes pharmaceutical companies such as J&J and Purdue paid him fees and honorariums to sell their drugs, not to educate doctors about opioids.
Back in 2012, J&J executives had a business plan for their Nucynta drug that noted spending on speaker programs was worthwhile because the events “often trigger first use” of a drug by doctors, according to company documents presented at trial by Oklahoma. J&J sales managers also referred to physicians as “targets” of their marketing efforts, the state said.
“I knew they deployed their sales reps to talk to doctors, but didn’t know they referred to the doctors as targets,” Portenoy said.
Portenoy switched sides last year after U.S. cities and counties agreed to drop their opioid lawsuits against him in exchange for his cooperation, according to court filings. He had been named a defendant in thousands of suits and was facing personal bankruptcy. Portenoy’s earlier assertions that opioid therapy was effective and safe for non-cancer pain was used in doctor-training videos funded by opioid makers and in the companies’ marketing brochures, he acknowledged in court papers.
The case is State of Oklahoma v. Purdue Pharma LP, CJ-2017-816, Cleveland County, Oklahoma, District Court (Norman).
(Updates with details from Portenoy testimony. An earlier version corrected sixth paragraph to remove brand-name references to opioids described in autopsy report.)
–With assistance from Tatiana Darie.