The House Energy and Commerce Committee, chaired by Rep. Greg Walden (R-OR), concluded its 18-month investigation into opioid distributors and wholesalers in West Virginia just before Christmas, 2018. The committee’s bipartisan report, to say the least, is shocking. (Read it [HERE].)

WV is the state struck hardest by the opioid crisis that has gripped the nation for the last several years. While the source of the problem could only be speculated before now, the report confirms what experts have been suspecting: Many of the issues in WV have been caused by systemic failures on part of opioid distributors and wholesalers. Most shockingly, however, is the revelation that the Drug Enforcement Administration has contributed to what is the worst public health crisis in American history. Over 42,000 Americans died from opioid overdoses in 2016, according to the report. That is more than died from car accidents, gun violence, and many other sources of untimely death.

The report chronicles the three largest opioid wholesalers in the United States and their role in WV’s opioid trade, legal or not — McKesson Corp., Cardinal Health and AmerisourceBergen. This investigation started in March of 2017, along with the probe of the DEA. Two distributors, Miami-Luken and HD Smith, were investigated in that September. The three wholesalers are, as of now, all facing lawsuits from various municipalities all over the country. McKesson just settled a $150 million lawsuit in California federal court for failing to report suspicious opioid orders. It is currently banned from selling in Florida, Colorado, Michigan, and Ohio.

The report found incredible levels of apathy and carelessness from all of the parties involved, which lead to suspicious activity going unnoticed. Wholesalers fill the orders that are given to individual pharmacies. Many of the amounts of narcotics ordered were odd but not reported to the DEA. For example, since 2005, over 900,000,000(!) doses of Hydrocodone and OxyContin have been filled in the state, much of them from rural areas. McKesson shipped nearly 10,000 pills per day to a now-closed pharmacy in the rural town of Kermit, which has a population of 400, in 2007. (Yes, you read that correctly.) This is nearly 36 times the limit the monthly dosage threshold the wholesaler had created that year. By not reporting such behavior, the report states that the wholesalers are complicit in growing black markets, trafficking, and the amount of overdose deaths.

If the wholesalers were to have reported this blatantly-illegal behavior to the DEA, the agency would not have been properly equipped to deal with the situation. As mandated under the Controlled Substances Act, the DEA is required to keep a database of illicit or suspicious orders sent to wholesalers and distributors. The report states that the DEA was not actively using this database until 2010. Additionally troubling, the DEA has not set up a standardized reporting method in order to assess the claims. This means that if the claims are reported at all, they are reported to local offices, which have different, oftentimes haphazard procedures of dealing with them.

The accusations are, on the surface, troubling only for WV, but the report is explicit in stating that the issues found in this state can likely be generalized for the country at large.

Upon the report being released in December 2018, the entities targeted by the investigation released statements ranging from denying responsibility to accepting their culpability in the epidemic. DEA spokesperson Wade Sparks stated that the report was eye-opening and that they want to “make sure what happened in West Virginia never happens again.” McKesson stated that it is working to address the crisis without mentioning its role in the report. Finally, Cardinal Health noted its “limited but vital role” in the opioid supply chain and that it is taking the report’s suggestions seriously.

The reactions from other companies involved were far less graceful. AmerisourceBergen downplayed its responsibility, stating that it has “virtually no interaction with physicians and limited legal ability to gather information on their practices and prescribing behavior.”

The committee suggests many courses of action to fix the abovementioned problems. Highlights include creating a DEA database of prescriptions collected from pharmacies that highlight suspicious doctors. Another is the review of pharmacies that have common ownership with ones with policy violations. (Read a condensed list written by the committee [HERE].)

The committee notes that this problem is multifaceted, and while this is one piece of the chain that must be fixed, there is still much work to do on the opioid crisis on part of the federal and state governments, as well as pharmaceutical corporations.

Teton Gravity Research produced the acclaimed Andy Irons Kissed By God that chronicles the much-to-short life of Surfing World Champion Andy Irons who tragically died as a result of an overdose.

The Ochs Law Firm is sponsoring a free showing of the film Wednesday, September 19, 2018 at the Historic Gryphon Theater in Laramie, Wyoming beginning at 7:30 PM.

Admission is free and all are welcome.

See the film trailer here:


While the opioid crisis has been dominating national headlines for months, denoted as one of the worst public health crises in the US’s history, children born addicted to opiates are hardly discussed. If a woman uses prescription painkillers while their child is in utero, the child has a substantial chance of developing neonatal abstinence syndrome. This is a generic term for those born addicted to drugs. Common symptoms include physical and neurological deformities, as well as long-term developmental problems.

Although it is impossible to establish exactly how many children are born in the United States with neonatal abstinence syndrome due to different reporting guidelines from state to state, it cannot be disputed that the number has been increasing throughout the last two decades. In 2013, more than three times as many kids were being treated for the condition than in 1999, as the opioid epidemic stated to sweep the country.

Litigators blame the practices of large pharmaceutical corporations and distributors for the increasing rate of neonatal abstinence syndrome and the nationwide opioid epidemic at large. Although the mothers used the drugs themselves, they were targets of predatory marketing practices, according to several lawsuits filed by state Attorney General offices around the country. Opioid distributors and manufacturers did not adequately tell potential users about the addictive nature of the medications. This, in part, led to some mothers giving birth to babies addicted to drugs. Some of these corporations include Purdue Pharma and Abbott Laboratories. Claims against corporate giants, such as these, have been filed in 8 states thus far.

Medical costs to care of neonatal abstinence syndrome is astronomical. Medical professionals estimate that it can cost an average of $260,000 in the first year alone. This costs only increases as the child gets older. They may start to develop psychological or social problems, which may require counseling and medication. Having a fund to help these children dramatically offsets the cost, especially considering the fact that the mothers were victims of unethical marketing practices.

For more information, as well as stories concerning individual children born addicted to opioids, read the article [HERE].


It was just over a year ago in July when I received the tragic news that one of my dearest friends had lost his teenage son to an opiate overdose.  It absolutely devastated him and his family.  Their 19-year-old son was the treasure of their lives, a straight-A student going into his sophomore year in College.  I would later learn that his opiate addiction stemmed from a surfing injury two years earlier, requiring shoulder surgery, and being sent home with a 60-day prescription of oxy.

His death was shortly after Ohio’s Attorney General filed a lawsuit against all nine major opiate manufacturers alleging that each was responsible for the public and fiscal decimation that was gripping the state.  Thereafter I endeavored to determine the extent of the crisis here in Wyoming.  What I discovered alarmed me.

To put things into context, West Virginia is often considered “ground zero” in the opiate crisis.  The state has been ravaged by opiates so much so that cities and counties have had to literally bring in mobile morgues because the coroner is already at maximum capacity.  The young lives, families and children affected by this epidemic could not be over-exaggerated.

Alarmingly, I would learn that more Oxycontin pills actually come into Wyoming than the state of West Virginia on a per capita basis.  After talking with people all over our state,  I learned of many tragic stories of young lives crushed and destroyed much too early because of this prescription drug.

I knew there were really only two solutions to this crisis.  The first, and best, was our Congress in Washington.  The second, in the alternative, is the private sector where attorneys, with the requisite experience and financial resources to fight Big Pharma (with its untold billions of dollars and a highly paid lobby), agreed to finally attempt to stop this National Health Crisis.

Initially it gave me comfort to know that Wyoming might be at an advantage for rescue with a licensed physician as our senator, Dr. Barasso.  I assumed that our senator would have a learned and therefore intuitive understanding of prescription opiates with their deadly addictive properties propelling this Crisis.

But the US Senate apparently lacks any apprehension of this National Health Emergency or otherwise willfully chooses not to hold accountable Big Pharma—a historically major and reliable political donor to some who serve us in Congress.  The Senate has offered no solution(s) to the greatest public health crisis of our time with the exception of seeking more federal funding.  There needs to be clear-eyed leadership in the Senate to finally hold Big Pharma liable for this moral outrage now killing more Americans each and every year than all who served and died in the 15 year war in Viet Nam

The Opiate Crisis is now claiming more than 170 lives every day.  The CDC announced that life-expectancy has – for the first time – decreased in America because of the prescription opioid crisis.  The US Surgeon General, an anesthesiologist, has publicly announced the need for all adult citizens to carry Naloxone, an opiate reversal agent, for emergency use for family and friends.

The people of Wyoming  – and every citizen of the United States – deserves better.  Change is needed.  Candidates who do not accept funds from Big Pharma may be our only hope.

 The below article was posted in the Jackson Hole Daily News on Thursday, May 17, 2018 in regards to the May 14th Teton County Board of County Commissioners meeting that took place with the state’s attorney general and Jason Ochs of the Ochs Law Firm.  Ochs strongly encouraged Teton County, and other counties across the state of Wyoming, that the time to join the opioid fight was now, and that only waiting would make matters worse.

See the article in full below:

Wyoming Attorney General Peter Michael brought an entourage to Jackson on Monday to tell Teton County commissioners they’d be better off not filing their own suit against opioid manufacturers and that the state was better positioned to lead the charge.

“To say that we as a state won’t be affected by litigation brought by others is simply not accurate,” Deputy Attorney General John Knepper Jr. said. “You bring the wrong claim, you get the wrong ruling by a judge, it becomes very very difficult for the state’s attorneys to undo that.”

The decisions by counties to go it alone aren’t cost-free to the state’s overall interests, he added.

The attorney general’s urging comes at a time when counties across the country are choosing to sue on their own as a way to hold opioid manufacturers accountable for deaths and other costs. More than 600 counties nationwide have filed complaints, something Knepper coaxed Teton County not to do.

But attorney Jason Ochs, suing on behalf of Carbon County, urged Teton commissioners to file suit and trust a jury to make things right.

The meeting’s purpose was to hear the state’s legal perspective on the opioid crisis and inform commissioners on the county’s options should they decide to pursue litigation. It was followed by an executive session with the attorney general and several more people from his office. Ochs was originally scheduled for an executive session as well, but that was crunched for time and didn’t occur.

One complaint already filed

On May 8 Carbon County — represented by Ochs Law Firm — became the first in Wyoming to file a complaint regarding opiate abuse with the U.S. District Court in Cheyenne. The 72-page complaint lists more than 15 opiate manufacturing and distribution companies accused of targeting susceptible prescribers and vulnerable patient populations, using multiple avenues to disseminate false and misleading statements about opioids, misrepresenting the risks and benefits of opioids, fraudulently concealing misconduct, engaging in other unlawful and unfair conduct and other allegations.

Carbon County has the third-highest number of opiate-related deaths per capita in the state, following Fremont and Uinta counties.

The complaint says that deceptive marketing schemes caused and continue to cause an increase in opioid prescriptions in Wyoming in order to increase profits. The argument is being used in complaints around the country.

The Northern Arapaho Tribe on the Wind River Reservation has also filed suit, with the addition that opioid abuse and addiction has hurt tribal communities especially bad. Data from the Centers for Disease Control and Prevention shows that Native American overdose rates from prescription opioids are higher than other races.

Each of the filed complaints nationwide have been consolidated before Judge Dan Polster in U.S. District Court in Cleveland, Ohio, for review in what’s called multidistrict litigation. Ochs said he’d recommend the Carbon County case and a Teton County case, if commissioners decide to go that route, be tried in Wyoming with a Wyoming jury because litigants have that choice.

The AG makes its case

The attorney general’s office said they’re already in the fight against opiate manufacturers, just through a different and in their mind, more effective route than private litigation. Knepper told the commissioners that “opioid addiction is a major issue” for attorney generals across the country.

“It is something the attorney generals are working on,” Knepper said. “We have been actively involved in this effort for the better part now of a year and a half.”

He proposed a multistate effort in which Wyoming is part of a large coalition of states working together, “actively investigating opioid companies and engaging in settlement negotiations.”

Wyoming entered a multistate investigation into Purdue Pharmaceuticals, known for the drug OxyContin, in January 2017 and other drug companies in the fall of 2017, as well as joining a coalition of 41 state attorneys general who subpoenaed opioid manufacturers in September. States work to divvy up documents; Knepper said his office is now reviewing 7.5 million pages.

Under the Wyoming Consumer Protections Act, the state can demand information without going to court. Engaging in litigation discovery outside of court, Knepper said, is a benefit of letting the state do its work and not going the private route.

Knepper presented a slide with the title “the attorney general should lead Wyoming’s efforts” that detailed the benefits to the county to let the state lead the charge. Factors mentioned included the lack of contingency fee arrangements — Ochs Law Firm receives a 25 percent fee if it recovers anything — the ability to pool resources, broader settlement and that “county lawsuits impede the attorney general’s ability to address all opioid issues implicating the state’s interests.”

“In sum,” the slide read, “the attorney general is in the best position to provide a centralized response to the opioid crisis, addressing the epidemic in all parts of the state, not just one county.”

Knepper said the state will continue to review records relevant to Wyoming and identify witnesses to bring forth Wyoming-specific evidence.

“Some states will sue soon and others will hold back a little bit,” he said. “That is not an arbitrary decision, that’s all I can say about that.”

A sense of urgency

In the meantime Ochs will continue trying to persuade counties to take action individually through the private sector if they want to join the fight and get a piece of the pie. He wants to see heads roll and people go to jail for their role in the estimated 170 opioid overdose deaths each day in the U.S.

“It’s always been my opinion as a litigator that there’s only one thing that equalizes the playing field with corporations that are Fortune 500 companies,” Ochs said. “And that one thing are 12 people in a box. We call that a jury. That’s what equalizes the playing field. And the only way you get to a jury is to file a lawsuit and get it in front of a community.”

Waiting for the state, he said, isn’t ideal.

“We’ve got to do something here,” Ochs said. ”And whether it’s sit on the sidelines and wait — which I wouldn’t recommend — or get involved in the arena, there’s only one way to assure there’s a potential to ensure a good outcome, in my humble opinion, and that’s getting in the arena.”

But with that in mind, Ochs said he’d like to work with the attorney general and not be at odds with the state.

“This is the first time I’ve been in a setting where I almost feel, subtly, a little bit of tension between where I stand and where the attorney general stands,” Ochs told commissioners Monday. “And I’m sorry for that. I am. I hope that’s just my own feelings this morning and not anything other than that. I don’t want there to be any wedge whatsoever driven between the private side and the regional side in this effort to stop what is without question, the greatest public health emergency of our century, of our generation. That cannot be over-exaggerated.”

Commissioner Paul Vogelheim was the only member absent. Commission chairman Mark Newcomb said he’d gauge the temperature of other commissioners Monday to see what information they might be interested in receiving from Ochs before moving forward — more of a straw poll, he said. He hopes to have an action item on the commission’s agenda by the June 5 meeting.

“I do feel like we need to get going on something here because it matters here in Teton County,” Newcomb said. “We have not faced the crisis in any severity that some of the other counties nationwide have, but it is here and why not address it as best as we can? I’d like to see us move forward with something.”

On May 8, 2018, Carbon County filed a 72-page complaint in US District Court naming more than fifteen opiate manufacturers and distributors across the country for alleged misrepresentation about the addictive properties of opiate medications.

On August 10, 2017, President Trump declared the opiate epidemic a National Emergency. 

According to the Center for Disease Control, opiate abuse kills 170 people per day, and the National Institute of Health declared the opiate manufacturers’ “aggressive marketing” as a major cause of the epidemic.

Carbon County is the first county in Wyoming to bring an action in the nation wide opiate litigation that has garnered tremendous attention in the past twenty-four months.  Carbon County joins more than 600 counties across the country in a joint effort to bring an end to the opiate epidemic.

Carbon County is represented by Jason Ochs of the Jackson-based Ochs Law Firm.  “Carbon County’s leadership is dedicated to bringing an end to this epidemic in their community and beyond.  I am hopeful that their leadership and commitment will motivate other counties in Wyoming to join forces in a state-wide effort to bring an end to the worst public health crisis of our time,” said Ochs.

The opiate lawsuits across the country have been consolidated before the Honorable Dan Polster in US District Court in Cleveland, Ohio for workup and discovery.  “Once discovery is complete, Carbon County will have the opportunity to have their case decided in Wyoming, by a Wyoming jury,” said Ochs.

According to a recent New York Times article, the top four counties in Wyoming with the greatest number of opiate-related deaths per population, in descending order, are Fremont County, followed by Uinta County, Carbon County and Natrona County.

According to the Wyoming Prescription Drug Abuse Stakeholders website opiates continue to wreak havoc in Wyoming.  Public resources, including EMS, law enforcement, family services, morgues and medical costs are all being depleted as a result of the crisis; damages that the lawsuit seeks to recover.

“Unless and until communities stand up against the opiate manufacturers and distributors, the problem will only get worse, and the tax payer will be left footing the enormous societal costs,” said Ochs.  “The leadership of Carbon County understands the immediacy and need for action.”

opiate abuse

Just within the past several months, new and staggering statistics have surfaced that really place into perspective the overall scope and devastation of the opioid epidemic that is currently ravaging just about each and every community in the country.

To begin with the Centers for Disease Control issued their annual Vital Signs report that details, among other things, the number of ER visits that were reported to be associated with opioid abuse.  The report concludes just over a 30% increase in ER visits from July 2016 to September 2017.  All indicators show the epidemic getting far worse than originally anticipated.  Read the vital signs report here.

Next the US Surgeon General, just this past month, made an unprecedented announcement advising in essence the need to have Narcan, the opiate-reversing agent, “within reach” and to know how to use it.  His statement read:

I, Surgeon General of the United States Public Health Service, VADM Jerome Adams, am emphasizing the importance of the overdose-reversing drug naloxone. For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life.


See more about the Surgeon General’s alert here.

Finally, counties, municipalities and other third parties continue to file lawsuits in Federal Court seeking to hold both manufacturers and distributors of opiates responsible.

With legal representation for said counties and municipalities across the country on a contingency-fee basis, there is zero risk and zero reason why counties and municipalities across the country should not be seeking redress and contributing to the fight to end America’s greatest public health crisis.

On September 27, 2017 I presented before the Wyoming County Attorney’s Association on the opioid crisis and the impact same was having on Wyoming.  The opioid crisis is  the worst public health crisis of our generation; far outpacing smoking.

Since 2015 approximately 25 states, counties and municipalities have filed lawsuits against the Opioid manufacturers alleging deceptive and fraudulent advertising.

The marketing blitz has worked extremely well (for the pharma co’s) as the numbers reflect:  more than 140 people die every day from an opioid drug overdose.

Withdrawal symptoms have been described in the medical literature  as being far worse than often the underlying pain that was being treated in the first place.  Young people have posted online videos of the traumatic withdrawals they have gone through, and they are absolutely heart breaking.  (See video here).

Remarkably, my impression has been that most public officials at the local level do not appreciate the true impact this epidemic is having in our communities.

President Trump announced on August 10, 2017 that he would be declaring the opioid epidemic a National Emergency yet, to date, he still has yet to do so.

Moreover, just yesterday, the Washington Post and 60 Minutes reported that Todd Marino, nominated for the country’s “drug czar”, received enormous amounts of campaign money from the pharmaceutical industry and sponsored legislation that hindered the Drug Enforcement Agency from being able to adequately and aggressively go after the opioid manufacturers.  See more here.   (While writing this article, Marino withdrew himself from consideration for drug czar, no doubt in light of the Washington Post and 60 minutes piece).

What does all this mean?  That the fight against the opioid manufacturers must be brought by the public, through their AG’s, their county attorneys, city attorneys or private lawyers.

Litigation against the manufacturers will be, and has been, extremely expensive.  The issues are complex and all consuming for most private firms; much less for small county attorney offices.  But the private sector is prepared to help, and can do so by fronting costs and expenses to counties and municipalities and taking on the stress of the litigation.

Wyoming and Colorado has yet to have a single county or municipality join in the recovery. Having grown up in Colorado and now living in Wyoming, it was of particular interest to me to see which counties in each state were the hardest hit by the opioid crisis.

According to the NY Times, the following represents the hardest hit counties in Wyoming in descending order:

  1.  Fremont
  2. Uinta
  3. Carbon
  4. Natrona
  5. Niobrara
  6. Laramie
  7. Goshen

The hardest hit counties in Colorado in descending order:

  1. Las Animas
  2. Pueblo
  3. El Paso
  4. Mesa
  5. Crowley
  6. Bent
  7. Lincoln

Absent counties fending for themselves, the likelihood of any recovery at the county level is extremely small.  Counties should not pass up the opportunity to join forces with qualified litigation firms in an effort to replinish much needed resources to combat this epidemic.

At my firm, we have joined forces with other prominent firms across the country to take on the opioid manufacturers the way in which they deserve to be battled.


opiate abuse

In a startling new study by the Boston Medical Center that will surely help the numerous counties and states persecuting opioid manufactures and distributors for the nationwide addiction epidemic, it was shown that one in twelve doctors was paid personally by an opioid manufacturer in a effort to promote their products. [Read the full study HERE.]

Most payments mostly consisted of paying for a doctor’s meal (93% of cases) or speaking fee (63%), where they speak at a conference to talk about a drug. The study showed that even if a doctor was paid a small amount, it lead to a higher narcotic prescription rate. Opioid manufacturers paid 68,177 doctors in some capacity for a total of $46 million spent. 83% of the money was spent on only 700 doctors.

Furthermore, the states hit hardest by the crisis also were the state where the most payments were made. Ohio, Indiana, and Pennsylvania, and New Jersey, which are some of the states hit hardest by the crisis, all are some of the states where doctors have received the most money in an effort to promote opioid use.

Names of both the physicians themselves and the pharmaceutical companies were not used in the report’s findings.

The data collected is from August of 2013 to December of 2015.  A 2013 law required all pharmaceutical companies to disclose any money given to doctors for the purpose of marketing. Without this regulation, the analysis could not have been done.

Scott Hadland, the study’s author, states that opioids are unique in that “…they are one of the only medications in the U.S. in 2017 where there are active public health efforts to reduce the prescribing of.” The revelation that the smallest of these payments has such a large effect is particularly disturbing, Hadland additionally mentions.

Fentanyl is one such drug that was peddled by doctors to the public. Of the $46 million total, $21 million was used to push this narcotic onto doctors and, by extension, their patients. It is usually meant to treat pain in cancer and patients that are near death. However, due to its strength, it is a drug that causes a large amount of overdose deaths, especially when it is combined with heroin. Many addicts turn to heroin because it is stronger and cheaper than prescription painkillers.

While a causal link has been found, more research must be done to determine the true extent these payments had on the epidemic. Hopefully, this is done sooner than later; 2017 is likely to have a record number of overdoses.

opiate abuse

Experts are urging the president to declare a state of emergency due to the severity of the national opioid epidemic.

President Trump campaigned on a promise of stopping the nation-wide crisis, which killed 33,000 people in 2015 alone. More Americans are addicted to painkillers and heroin than tobacco, a truly startling statistic. As he said in his inaugural address: “ drugs (opioids) have stolen too many lives and robbed our country of so much unrealized potential”. The death toll is climbing. 142 people die from an opioid overdose everyday. Regardless of partisanship, Washington saw it was time to take action.

After Trump took office in January, he created the President’s Commission to Combat Drug Addiction and the Opioid Crisis. Chris Christie, the current governor of New Jersey and former Republican presidential candidate, is its leader. He believes that the issue is serious enough that the president should declare a state of emergency. Doing so would benefit legislative outlooks and raise public awareness of the crisis. Christie wants to “awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will”. The commission aims to put pressure on Congress in an effort to refocus funding toward helping those affected by the epidemic. They suggest this effort should take shape in the following ways, among others:

  • Adding a breadth of drug rehabilitation options under Medicaid
  • Encouraging the creation of non-opioid pain medications
  • Increasing protection under “Good Samaritan” laws to protect those reporting overdoses and other opioid-related injuries

They also recommend the president could use the bully pulpit, a method used to capture the attention and communicate broadly with the people, to raise awareness and bring solutions to light.

Opioid addiction has been an increasing issue in United States since the mid-1990s. When pharmaceutical companies introduced slow-release, “addiction-proof” drugs, doctors started prescribing them at higher rates, as they were reluctant before to give painkillers to their patients after the morphine crisis several decades earlier. Clearly, the new opioids were not “addiction-proof”; if they are crushed, they give off an even stronger high. This discovery in conjunction with doctor shopping, fake prescriptions, and gross overprescribing has landed the country in the state it is in today.

Licit opioid abuse is a gateway to heroin abuse. Combining the two nearly always leads to an overdose.

Hopefully, President Trump will heed the warning from his commission and declare a state of emergency to combat the crisis at the national level.

For a more in-depth look, read the Washington Post article on the state of emergency HERE.