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Thursday brought a change in tempo for West Virginia’s ongoing trial against several opioid manufacturers accused of using deceptive practices the state says led to the mass distribution, and subsequent mass addiction, of prescription opioid medicines.

The first eight days of the trial proceeded at a brisk pace, with testimony and prerecorded video depositions playing back to back until at least 5 p.m., and later on most days. On Thursday, the ninth day of the trial, Mercer County Circuit Judge Derek Swope, who is presiding over the case, released the court at about 11:30 a.m.

From then until about 4:30 p.m., counsel for the state, Attorney General Patrick Morrisey and counsel for the defendants in the case — which include a group of companies that are part of Allergan Finance LLC, Teva Pharmaceutical Industries Ltd. and Janssen Pharmaceuticals Inc., which is owned by Johnson & Johnson — shuffled between closed-door meetings with each other and themselves.

Morrisey declined to comment on the record Thursday afternoon about what the meetings regarded.

On his way out of the Kanawha County Courthouse Thursday evening, the attorney general stopped by the Kanawha County Commission meeting, where he announced to those in attendance that the opioid trial could go late into May, but that “could” change.

A source close to the trial said Thursday they believed parties were meeting to mediate a potential settlement agreement. While a judge must approve, a settlement can be reached at anytime during litigation.

Morrisey originally filed the lawsuit in Boone County Circuit Court in 2019. It later was moved to West Virginia’s Mass Litigation Panel, where Swope became the presiding judge.

In the case, the state alleges the pharmaceutical companies created a public nuisance and violated the West Virginia Consumer Credit and Protection Act by mischaracterizing and failing to disclose the serious risk of addiction of prescription opioids medications.

West Virginia also alleges the companies overstated the benefits of chronic opioid therapy and promoted the idea that doctors should prescribe higher dosage amounts without disclosing the greater risk involved.

Attorneys for the pharmaceutical companies have argued that their sales representatives appropriately and legally marketed their opioid medications, saying documentation from the U.S. Food and Drug Administration would support their claims.

They’ve also argued that their respective opioid medications took up so little of West Virginia’s overall opioid market share, with nearly every relevant medication taking up less than 1% of the total, that they couldn’t be declared a public nuisance.

The state is seeking an injunction to require the companies to accurately disclose the “significant risk and limited benefits” of opioid drugs and not to market opioid medications as front-line treatment for chronic pain.

The state additionally is asking Swope to assess civil and other financial penalties against the companies. Those penalties would be dispersed among 54 of West Virginia’s 55 county governments and other municipal governments.

Thursday morning, counsel for the state called to the stand Dr. Andrew Kolodny, medical director of Opioid Policy Research at the Heller School for Social Policy and Management at Brandeis University.

During his nearly three hours of testimony, Kolodny broke down how he believes the companies named — among others — collaborated in the 1980s and 1990s to increase prescriptions for opioids across America “and especially in West Virginia.”

Throughout this time, Kolodny testified, pharmaceutical companies worked together with professional medical organizations — specifically those dedicated to managing chronic pain — to change prescriptive guidelines for opioids and erode barriers that previously kept doctors from overprescribing them.

These efforts, he said, had two central themes: downplaying the risk of opioid addiction to physicians and exaggerating the benefits of using opioids, especially for long-term pain.

This messaging, although widely disseminated through the companies, was the product of a handful of poorly interpreted — and evaluated — pieces of medical literature, Kolodny said.

“Adequate evidence that patients can take opioids every day for weeks, for months, for years and it will improve their quality of life ... does not exist,” Kolodny said. “The best available evidence we have shows us that patients on long-term opioids are not doing well.”

Counsel for the defendants, namely Michael Yoder, who is representing Janssen, issued several objections to Kolodny’s testimony Thursday, questioning his authority to comment on the marketing of opioids and the scope of his responses.

Swope allowed the testimony to continue, with Mimi Liu, counsel for the state, leading. Liu did not complete her questioning by the time the court adjourned Thursday morning.

The case is scheduled to resume at 8:30 a.m. Friday.

Caity Coyne covers health. She can be reached at 304-348-7939 or caity.coyne@hd Follow @CaityCoyne on Twitter.

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