Jan Rader left the defense without questions on Friday.
The Huntington Fire Chief detailed life on the frontlines of an overdose epidemic that she says wreaked “carnage” across her community. Rader was the last person to testify during the first week of a landmark trial brought by Cabell County and the City of Huntington against the “Big Three” drug distributors.
Plaintiffs argue the distributors — Cardinal Health, McKesson and AmerisourceBergen — are responsible for approximately $2 billion in damages caused by the 80 million pain pills the companies pumped into the area over an eight-year period starting in 2006. They say the pills fueled the addiction crisis that is now driven by illicit drugs like heroin, meth and fentanyl.
“When I started my career in August of 1994, I didn’t see a lot of death. I didn’t see overdoses,” Rader said from the witness stand in the federal courtroom in Charleston. “Mid-2000s, that started changing. We started seeing overdoses. And at these scenes we would see pill bottles.”
For nearly an hour, Rader, dressed in uniform — a black suit jacket with gold buttons and Huntington Fire Department badge — described the change in the role of her department that she says is the result of increase in drug use.
Calm and even-paced, she described responding to overdose calls at restaurants and dentists offices, for people as young as 12 and old as 78. In 2010, Rader said the fire department responded to just over 1,200 total emergency calls. In 2017, they responded to 1,241 overdose calls alone — at the peak of the crisis, firefighters might see five overdose deaths in a month, Rader said.
“My firefighters suffer a lot from compassion fatigue, PTSD,” Rader said. “They’re not just going [out] on overdoses, they’re going on overdoses of their classmates from high school… their friends.”
The cost of the substance use disorder crisis, according to Rader, has been monumental. She said families are broken; children have lost parents and parents lost children to the disease. School systems have been left to support students who are living with trauma.
The city and county are doing their best to put in place programs to connect people who use drugs with treatment and people who respond to overdose calls with mental health support services, Rader said, but both are costly.
That’s part of the reason the plaintiffs are seeking money from the distributors in this case. The defendants argue that the City of Huntington and Cabell County receive funds through federal grants to support such programs and are making the case that needs are already being met. But Rader said on Friday that the grants are not sustainable and the funding is not enough.
“We need the expansion of so many programs. We need sustainability because this is not going to go away,” Rader said.
Leading up to the trial, the drug distributors made efforts to block Rader from testifying. They argued that “personal stories of addiction,” had no place in the trial, and asserted that those are what Rader would bring.
But during Friday’s testimony, the distributors offered few objections as Rader spoke.
And when she finished, the defendants didn’t press back. They asked nothing.
A different tone
The quiet response to Rader’s testimony was not representative of the approach taken by the drug distributors earlier in the week.
Over the first four days of trial, and in response to testimony by witnesses ranging from former West Virginia state health officer Dr. Rahul Gupta to Huntington Quick Response Team coordinator Connie Priddy, attorneys for Cardinal Health, McKesson and AmerisourceBergen largely made the case that the West Virginia doctors who prescribed the pain pills — not the companies that supplied them — were responsible for the excessive presence of opioids in the Mountain State.
They also pointed to West Virginia’s historically poor health outcomes — the state has one of the nation’s highest prevalence of illnesses like heart disease, cancer and diabetes — as a reason for the number of opioids prescribed.
Gupta pushed back during cross-examination, and said that neither the high rates of disease, nor the state’s heavy labor economy (another argument made by the defense), required the number of prescription opioids that were being supplied. But attorneys for the drug distributors were quick to move on to their next point and would not allow him to provide further context when answering questions about risk factors in the state.
Perhaps one of the more surprising arguments to be made by the defense during the week was the assertion that the overdose crisis was not the direct result of prescription opioid pills at all, but due to illicit drugs that were circulating the state.
Laura Wu, an attorney for McKesson, made note of the fact that data collected by Cabell County EMS and the Quick Response Team does not record the specific type of drug that was used in a suspected overdose run, and pointed to rising rates of heroin, fentanyl and meth in Cabell County. She cited data showing the average age of a prescription opioid recipient in Cabell County is 55 to 60 years old. The average age of an overdose victim is 37, Wu said.
The argument largely contrasts with years of research showing prescription opioids are a gateway drug. When people living with substance use disorders are prescribed opioids like OxyContin for extended periods of time, they get hooked. Once the prescriptions run out, people turn to street drugs to fill the need.
But the argument made by Wu, calling into question the gateway theory, is one that’s come up in other trials recently. It’s been argued in California, where four major pharmaceutical companies are on trial, too.
All parties will be back at the Robert C. Byrd U.S. Courthouse in Charleston next week to continue arguments in the case.
On Monday, Craig McCann, an expert witness regarding the U.S. Drug Enforcement Agency database, is expected to testify. That will be followed by four current AmerisourceBergen employees. Those testimonies and cross-examinations will likely go on until Thursday, when a former crime analyst for the Huntington Office of Drug Control Policy, Scott Lemley, will take the stand. At the end of the week, plaintiffs hope to hear from Dr. Joe Werthammer, a practicing neonatologist at Marshall Health.
All of this is subject to change based on timing.
Reporter Eric Eyre contributed to this story.