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 Dr. Russell Portenoy, a professor at the Albert Einstein College of
Medicine, was an early advocate for the use of opioids for chronic
pain, a position he shared in medical journal articles, with
regulators, at physician conferences and in other forums. He also
was named as a defendant in some of the lawsuits filed by cities,
counties and states seeking to hold opioid makers - including Endo
and Mallinckrodt Plc - and their distributors liable for the cost of
the U.S. opioid epidemic.
But Portenoy began talking to plaintiffs' lawyers as early as
January 2018 and later struck a deal with the plaintiffs to serve as
a cooperating witness, the records show. In exchange for his
dismissal from the suits, Portenoy provided the plaintiffs with
documentation of opioid makers' payments to him over the years, as
well as a 36-page declaration that lays out what he would say on the
witness stand.
Portenoy's previously confidential cooperation agreement and
declaration were made public Friday as a part of a discovery ruling
by David Cohen, a special master in the federal court in Cleveland,
Ohio, where hundreds of the opioid lawsuits have been consolidated.
In an email, Cohen said it was possible the records should have been
filed under seal out of public view.
Their disclosure offers a glimpse into the largely secretive
evidence gathering phase of the litigation. Purdue executives have
said the privately-held company is considering bankruptcy in the
face of its potential liability. The company avoided having to stand
as a defendant in a trial scheduled for May in Oklahoma by agreeing
to pay the state $270 million.
Portenoy could not be reached for comment. His lawyer did not
immediately respond to an email seeking comment.
Purdue spokesman Bob Josephson declined to comment on Portenoy's
declaration and new role in the litigation.
Other companies, including Endo and Mallinckrodt, did not
immediately respond to requests for comment.
Portenoy, who has held leadership positions at Memorial
Sloan-Kettering Cancer Center and Mount Sinai Beth Israel, was among
the first physicians to espouse opioids as an option for the
treatment of chronic pain, a condition that afflicts tens of
millions of Americans, in medical journal articles published in the
1980s and 1990s. Later, he shared his views with physicians at
conferences and in training videos sponsored by opioid makers, he
said in the declaration.
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Previously, physicians had been trained to reserve opioids for
cancer and end-of-life pain. Opioids are chemically similar to
heroin and the risk of addiction was viewed as too great for their
widespread use.
In his declaration, Portenoy said he never altered his positions
because of opioid makers' payments for research, speeches,
consulting and other work. But, he said, the companies paid only for
work that supported their interests and cited it selectively "to
promote opioids by referencing the positive statements that I made
repeatedly without providing the background, analysis of the
literature, and cautions that accompanied these positive
statements."
These "unbalanced communications" encouraged the prescribing of
opioids to patients unsuited for them and by physicians who lacked
the skills to manage addiction, abuse and overdose, Portenoy said.
All of this, he concluded, "contributed to the rising incidence of
drug addiction and overdoses."
Opioids are involved in about 50,000 deaths a year in the United
States. In an effort to staunch the toll, the U.S. Centers for
Disease Control and Prevention in 2016 recommended against opioids
as a first-line treatment for chronic pain.
In a tentative decision issued on Friday, special master Cohen ruled
that Portenoy may serve as a witness for the plaintiffs - just not
in the first trial scheduled to take place in federal court in
Cleveland later this year. Cohen was responding to a complaint from
the defendant companies that they had inadequate notice of
Portenoy's new role.
Josephson said Purdue believed the special master's ruling was
appropriate. He did not elaborate.
(Reporting by Lisa Girion in Los Angeles and Maria Caspani in New
York; Editing by Diane Craft and Daniel Wallis)
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