Dive Brief:

• The Healthcare Distribution Alliance (HDA) is actively fighting against legal claims that its members are largely responsible for the opioid epidemic.
• The most recent case comes by way of Madison County, Elwood and Alexandria, in Indiana, where a lawsuit is being filed to hold "the companies that started this" accountable, Elwood Mayor Todd Jones said, according to The Herald Bulletin.
• Facing lawsuits nationwide, a member of the HDA told the media outlet it is taking steps to address the crisis. However, its members should not be blamed as "we don't make medicine, market medicines, prescribe medicines, or dispense them to consumers."

Dive Insight:

The opioid epidemic is now a public health emergency, and government authorities are scrambling to find ways to stem its effects.

The White House reports more than 300,000 U.S. citizens have died from opioid overdose since 2000, causing drug overdoses to outnumber both traffic and gun-related deaths.

Beyond the high death toll, the epidemic is having widespread effects on the U.S. economy as workers are displaced or disabled due to addiction.

The health crisis is "ravaging America," according to a White House statement, which added "will only get worse unless action is taken."

Last year's declaration of a public health emergency was the first step to take action, but "the best way to prevent drug addiction is to prevent people from abusing drugs in the first place," according to President Donald Trump.

But doing so requires answering an elusive question: who is responsible for the opioid epidemic?

Many lawsuits are casting blame upon pharmaceutical supply chains, for their failure to stem excess distribution of the drugs — a responsibility the HDA contests:

"Distributors respond to demand in the market for medicines — they don’t create it. Expecting distributors to have unilaterally stemmed the flow of opioids — a flow that increased yearly with the explicit oversight and approval of the (Drug Enforcement Administration) — is a transparent attempt by former DEA officials to shift the blame for their own failed approach to regulation during the growth and peak of the epidemic."

The HDA argues the DEA is the agency responsible for coordinating enforcement efforts throughout the pharmaceutical supply chains, using its database to track and contain the flow of drugs between manufacturers, prescribers, healthcare service providers and distributors.

Still, a look at the pharmaceutical supply chain and recent cases suggest enforcement may be too little, too late, compared to prevention efforts.

Cardinal Health recently agreed to pay the Department of Justice $44 million to settle civil penalties from a 2012 DEA case, which argued the distributor was negligent in its reporting duties to the DEA. As part of the agency's drug enforcement process, pharmaceutical suppliers are required to notify regulators of large or frequent orders.

If such reports are not filed, either by distributors or the ultimate healthcare service providers, including retailers like CVS, the DEA cannot spot and enforce instances of drug abuse. Modern market dynamics further complicate the issue, as the rise of e-commerce and delivery services may facilitate illicit access to such drugs.

As the opioid crisis continues to unfold, and lawsuits pile up, the entire pharmaceutical supply chain is being forced to take a deeper look at its enforcement and reporting practices.

"For our part, we’re ready to move forward with practical solutions to improve communication between all entities in the supply chain and with law enforcement to mitigate abuse and misuse before it occurs,” the HDA said in a December statement, which simultaneously sought to contest claims of distributor responsibility for the crisis.

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