Photo by Lauren Peace

This story will be updated as closing arguments in the trial continue. To read more about what the City of Huntington and Cabell County argued, click here.

During closing arguments in the landmark opioid trial in Charleston, an attorney for drug distributor AmerisourceBergen said the company is sympathetic to Huntington and Cabell County residents who are dealing with the opioid crisis. 

But the company again denied that it’s to blame for the area’s high volume of 81 million prescription opioids that entered the community over eight years, and called the money sought by Cabell County and the City of Huntington as a request for a “blank check” during Tuesday’s closing arguments. 

“They want a check,” attorney Bob Nicholas said. “They’re asking for a check. I’d say they’re asking for a blank check, but that’s not technically true. They’re asking for a check for two and a half billion dollars, which might as well be a blank check.”

After lawyers for Huntington and Cabell County gave their closing arguments Tuesday morning, AmerisourceBergen was the first of the three drug distributors on trial to respond. The other two, Cardinal Health and McKesson, will give their arguments Wednesday.

In nearly two hours of closing arguments, Nicholas said the area’s increase in pills was due to a new standard of care doctors used to treat pain in the early 2000s. Any systemic failures in reporting suspicious orders are the fault of the U.S. Drug Enforcement Administration, Nicholas said, with which the company says it’s always been in compliance. 

“Every witness in this case has confirmed what really happened here,” Nicholas said. “Licensed physicians chose to address the issue of pain in Huntington and Cabell County by prescribing more opioid medication.”

Attorneys for the city and county have argued that the distributors should be held responsible for a volume of 81 million pills that flooded their community in the span of eight years. Plaintiffs described the number earlier today in their own closing arguments as “mountainous and astronomical.”

Expert witnesses for the city and county, including former DEA official James Rafalski, have faulted companies like AmerisourceBergen for not properly reporting suspiciously large orders of pain pills to the DEA. 

Nicholas disputed the validity of Rafalski’s testimony altogether, saying that the plaintiffs’ use of it “undermines” credibility.

Instead, Nicholas argued it’s not a distributor’s responsibility to cancel orders and shipments called in by doctors, and that doing so would have been inappropriate.   

“This expert looked at you and everyone with a straight face and he testified that these distributors should’ve blocked 90% of the opioid medications to Cabell and Huntington during all the years it issued,” Nicholas said. “It was preposterous because it assumed that almost all of the doctors in the county and the city didn’t know what they were doing and had bad intentions.” 

Nicholas said that had the distributors canceled orders, patients who were in need of the pills — like those in hospice or with cancer — would have lost access to their painkilling medication. 

“Distributors should not second-guess prescribers. It’s dangerous to do that,” Nicholas said. “There are real patient access risks in arbitrarily cutting supply.”

Attorneys for Cardinal Health and McKesson, both of which are slated for closing arguments Wednesday, have used witness testimony to distance themselves from the city and county’s “gateway effect narrative” that distributors had a role in heroin abuse. 

The other two companies will present to the court Wednesday at 9 a.m., followed by rebuttal from the plaintiffs, which will conclude the trial. U.S. District Judge David Faber will decide on a verdict in the coming weeks.

Emily Allen is a Report for America corps member, and the community watchdog reporter for Mountain State Spotlight.

Lauren Peace is a Report for America Corps Member who covers public health.