Lawyers for Baltimore City on Wednesday told a judge two drug distribution companies should have to pay $5 billion to curb the raging opioid epidemic here.

The approximately weeklong bench trial presided over by Circuit Judge Lawrence P. Fletcher-Hill kicked off with the testimony of a public health professor the city hired to create a detailed plan to tackle the opioid crisis.

Wednesday’s proceeding is the second phase of Baltimore’s civil case against drug distributors McKesson and AmerisourceBergen, now known as Cenora. A jury in November ordered the companies to pay $266 million for flooding Baltimore with hundreds of millions of addictive opioid painkillers from 2006 to 2019.

Now it’s up to Fletcher-Hill to determine how much else, if anything, the drug distributors must pay to resolve the crisis jurors found them liable for. Baltimore initially asked Fletcher-Hill to make the companies pay $11 billion but reduced its monetary demands following the first trial.

Unlike the monthslong jury trial that ended in November, lawyers did not give dramatic opening statements. Instead, they submitted arguments in writing before this so-called “abatement phase” trial began.

Attorneys for Baltimore argue McKesson and AmerisourceBergen should pay at least $5 billion to offset the damage they caused by flooding the area with addictive painkillers with little regard for the havoc the companies knew they would wreak.

Their reckless distribution of opioids, the city said, hooked a new generation on painkillers. They then overdosed and died at staggering rates after moving on to heroin and much more potent fentanyl when their prescriptions ran out.

“The only viable remedy to reduce the nuisance and minimize its effect is to require Defendants to fund a plan to abate it,” city lawyers wrote.

Attorneys for the drug distributors argue the city is abusing the civil justice system to force two companies to pay for societal issues they had no role in.

They called the city’s abatement plan a “sweeping, 15-year social policy plan related to opioid addiction and many other social issues — e.g., homelessness, re-entry after incarceration, foster care, job training, food support, and bolstering the health care workforce.”

“That type of public policy-making is for the General Assembly, not a Court sitting in equity in a lawsuit involving just two wholesale distributors,” the companies’ lawyers wrote

The first witness Wednesday was Susan G. Sherman of the Johns Hopkins Bloomberg School of Public Health, a social and behavioral scientist whose decades of research focuses on people who use opioids, primarily in Baltimore.

Sherman highlighted the 91-page report she prepared before the trial that made recommendations she predicts in 15 years would bring down the fatality of overdoses by 23%, reduce initiation of nonmedical prescription opioid use by 7.5% and decrease the prescribing of opioids by approximately 55%.

Sherman’s plan calls for dramatically expanding access to medication-assisted opioid treatment — regarded by experts as the most effective way to treat opioid addiction. It would also create more programs to reduce the deadliness of drug use and its side effects and offer education campaigns to allow officials to better respond to the crisis.

She called it “a full response to the opioid epidemic.”

Sherman also proposes expanding measures Baltimore already has, like the distribution of the opioid overdose-reversing drug naloxone and providing clean syringes to reduce the risk of diseases like HIV and Hepatitis B.

“It’s a philosophy of meeting people where they are in their drug use,” Sherman testified.

Her plan also calls for some initiatives that would be novel in the city, such as overdose prevention sites, which provide people who use opioids a place to administer drugs under the supervision of medical professionals with life-saving resources available. There are at least 200 such places, also known as safe consumption sites, around the world but only two in America, located in New York City, Sherman’s report says.

“Despite millions of injections taking place in OPSes worldwide, not one has resulted in a fatal overdose,” she said.

Sherman testified that overdose prevention sites have led to people stopping drug use and entering treatment. She said there are plans to open such operations in Rhode Island, Vermont and Minneapolis.

Under her plan, the percentage of opioid users in the city who were in treatment would climb from 13% to 41%, she testified. She calls for more easy-to-access treatment programs like Project Connections at Reentry, a van that offers opioid medications to people without identifications or health insurance outside the Baltimore Central Booking & Intake Center.

She also called for more wrap-around services for people in treatment, including transportation, housing support, nutritional assistance, job training and mental health care.

“It’s important for people to have stability — food, housing, mental health care — to be successful in treatment,” Sherman testified.

_____

©2024 Baltimore Sun. Visit baltimoresun.com. Distributed by Tribune Content Agency, LLC.