A doctor who once advocated for the use of addictive medication to manage pain will serve as a plaintiffs’ witness against drug manufacturuers.
Dr. Russell Portenoy, a professor at the Albert Einstein College of Medicine and an early physician ally of Purdue Pharma LP. whose views helped drive the push for addictive pain relievers for common aches and pains in the United States, has agreed to act as a witness and testify against the OxyContin maker and other drug manufacturers. Portenoy, who has held leadership positions at Memorial Sloan-Kettering Cancer Center and Mount Sinai Beth Israel, openly advocated for the use of opioids in medical journal articles, with regulators, at physician functions. He also was named as a defendant in some of the lawsuits filed by cities, counties and states seeking remedies from Endo and Mallinckrodt Plc, and their distributors.
According to court records, knowing he would be put in the hot seat, the doctor began reaching out to plaintiffs’ attorneys in early 2018 and struck a deal with the plaintiffs to serve as a cooperating witness in exchange for being dismissed from the litigation. Portenoy provided the plaintiffs with documentation of opioid makers’ payments made directly to him over the years for promoting the addictive drugs.
Portenoy’s previously confidential cooperation agreement and declaration were made public this month part of a discovery ruling by David Cohen, a special master in the federal court in Cleveland, Ohio. The release of these documents uncovers some of the controversial discovery documents sought in the case.
Purdue executives have said the company is considering bankruptcy in the face of pending liability, and it already avoided having to stand as a defendant in a trial scheduled for May in Oklahoma by agreeing to settle with the state for $270 million. Portenoy 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,” his declaration states.
Prior to advocating for opioids as an effective method of pain management, doctors were trained to use these drugs only as a last resort for severe cancer and end-of-life pain. Opioids are chemically similar to heroin and the risk of addiction was viewed as too great for any other use.
In his declaration, Portenoy said he “never altered his positions because of opioid makers’ payments for research, speeches, consulting and other work.” However, he admitted the companies paid only for work that supported their interests and use this “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. And, this ultimately “contributed to the rising incidence of drug addiction and overdoses.”
In a tentative decision issued, special master Cohen ruled that Portenoy may serve as a witness for the plaintiffs. However, he will not be allowed as a witness in the first trial scheduled to take place in federal court in Cleveland later in 2019. This is because the defendants in the first round issued a complaint that they had not received timely notice of Portenoy’s position in the case.