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This article was originally published by L3: Long Leaf Law, The blog of the North Carolina Bar Association. To read this article in its original publication and with full footnote citations, please click here.


The opioid epidemic is an American tragedy. It is difficult to convey the breadth of the epidemic with a single statistic, but let this sink in: For every person killed by gun violence, three people will die from an opioid overdose.

As the epidemic worsens, local governments are scrambling for solutions. They are also scrambling to keep up with the costs—the public health, law enforcement, public employment, and other costs that the opioid crisis has left on their doorstep. With insufficient financial assistance from Congress and state legislatures to cover these costs, local governments are turning to the courts.

Across the nation, cities and counties are suing opioid drugmakers and distributors. These lawsuits seek to hold drug companies accountable—at least in part—for the opioid epidemic. No North Carolina city or county has filed a lawsuit of this kind yet, but they surely will soon.

The authors of this article—two litigators and their future colleague—would like to explore this litigation in three parts:

The first part gives a brief overview of the costs of the opioid epidemic on North Carolina and its local governments. The second part discusses state and local government litigation against drug companies in other states—essentially a preview of what future litigation in North Carolina might look like. The third part gives the authors’ predictions for the litigation, along with recently released information about a number of large settlements.

The Costs of North Carolina’s Opioid Epidemic

Most North Carolinians are aware of the opioid epidemic, but many do not realize just how hard this epidemic has hit our state.

According to a recent study, four of America’s worst cities for opioid abuse are in North Carolina. In the North Carolina city topping that list, approximately 11.6% of the population abuses opioids. If that statistic is not sufficiently shocking, then consider this: In that same city’s neighboring county, the ratio of opioid overdoses to traffic fatalities is 2 to 1. In short, North Carolinians are suffering at unprecedented levels.

North Carolina’s epidemic is not isolated to a few communities, however. Across the state, approximately 12,000 people have died from opioid-related overdoses in the past two decades. That death rate is rising dramatically: Over the next five years, opioids are projected to kill an additional 7,000 North Carolinians.

As this plague spreads across North Carolina, so do its costs. The Center for Disease Control and Prevention estimates that the opioid crisis costs North Carolina over $1.3 billion each year. From the societal impacts of drug use (for example, the breakdown of family units) to increased crime rates, every new opioid addiction in North Carolina carries a cost. On a granular level, a recent study by the U.S. Department of Health and Human Services identified the number of emergency room visits and other medical costs that occur on average for every single overdose, and it concluded that for every single overdose, there are approximately $4.35 million in healthcare costs.

To defray these costs, the federal government has begun funneling additional resources to North Carolina. In May of this year, Governor Roy Cooper announced that the State had received a $31 million grant through the federal 21st Century Cures Act. To be sure, these funds will provide much needed relief. As illustrated above, however, they will hardly offset North Carolina’s financial burden. This is especially true at the local level, where cities and counties continue to foot much of the bill.

As the frontline of defense in the opioid crisis, cities and counties face an array of costs that are unique to local government. Broadly categorized, these costs include:

These costs are unsustainable for local governments. As a means of offsetting these costs, local governments have been seeking to hold drugmakers and distributors accountable.

Overview of Local Government Opioid Litigation

Much like the tobacco litigation of the 1980s, the opioid crisis has government officials knocking down the courthouse doors. In 2017 alone, the pharmaceutical industry faced an onslaught of more than 100 lawsuits.

The plaintiffs in these lawsuits cross the government spectrum. They include:

In a major development last month, a Judicial Panel on Multidistrict Litigation consolidated 66 federal lawsuits spanning 11 federal districts and 9 states into a must-watch MDL: the “National Prescription Opiate Litigation.”

So what, exactly, are these governmental plaintiffs accusing Big Pharma of doing? To briefly summarize, the lawsuits allege that the drug manufacturers and distributors created and accelerated the opioid crisis through acts that were reckless. The lawsuits allege the following acts:

Armed with these allegations, local governments have asserted a number of legal theories against the drug companies. The most common claims are:

In most instances, these lawsuits seek statutory treble damages, punitive damages, and attorneys’ fees.

Predictions for the Litigation

The opioid litigation is still in its infancy, but the authors believe that the potential exposure for the drug companies—even the defense costs alone—could be significant.

There are two reasons the authors share this view:

First, at least some of these government lawsuits have the potential to proceed to discovery, which, of course, substantially increases the chances of settlement. To date, the lawsuits described above have either survived motions to dismiss or (in state court, at least) are proceeding to discovery.

In the City of Chicago’s lawsuit, for example, the federal district court “reject[ed] defendants’ argument that their alleged misrepresentations cannot be the basis for any fraud-based claim,” and it denied the defendants’ Rule 12 motions on key claims. The case is now in discovery, and the city has filed a motion to compel one of the drug company defendants to produce documents from its employees who were responsible for opioid marketing.

Similarly, in the City of Everett’s lawsuit, the federal district court largely denied the defendants’ Rule 12 motion, and it granted the City an opportunity to amend the claims that were subject to dismissal. As these rulings illustrate, at least some of these lawsuits have the potential to proceed to discovery.

Second, drugmakers and distributors have already paid large settlements related to their alleged role in the opioid epidemic. In the past year alone, these settlements have included the following:

These large settlements may be further motivation for local government plaintiffs to join the opioid litigation in the coming months.


In view of the wave of opioid lawsuits across the nation, it is only a matter of time before the first lawsuits are filed by local governments in North Carolina.

The authors hope that this article may be useful in inviting a dialogue on this important topic. We are genuinely interested in hearing from local government attorneys about their city or county’s experiences with the opioid epidemic, and we invite your thoughts by phone or e-mail.

* This article states the authors’ personal views, not necessarily the views of our colleagues or of any client.

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