Highlight on West Virginia: Doctors on the hook for enabling addictions

West Virginia’s newest tactic for fighting the prescription drug addiction epidemic is finally getting some national attention. The state with the third-highest number of opiate prescriptions in 2014, according to a recent report, decided in May 2015 to allow those addicted to pain medication to sue their doctors and pharmacies for their role in furthering the addiction.  CBS News recently investigated the pain clinics operating in the state, finding that even those ordered to shut down remain in operation. This is a hot topic in a state with high overdose rates, where President Obama himself recently visited to discuss recent anti-drug efforts.

State Supreme Court case

In May 2015, the West Virginia Supreme Court ruled that although the patients themselves might be negligent or at fault in their own addictions, this does not bar recovery from the doctors and pharmacies that enabled the addictions to continue. Questions of fault and negligence on the part of the patients are for the jury to decide, and the court noted that even undisputed facts can lead jury members to different conclusions.

Some may think that this decision places doctors in an unfair, impossible position, but a review of the underlying facts is important to understanding why the majority ruled as it did. This appeal stemmed from eight civil actions against three pharmacies, the Mountain Medical Center, and four physicians working at the medical center. Most of the patients sought treatment at the medical center following injuries in vehicle accidents or the workplace. The patients were prescribed painkillers to which they ultimately became addicted. The FBI raided Mountain Medical Center, revealing violations of federal and state law governing the prescription of controlled substances. Some of the physicians lost their medical licenses and served time for the offenses.

The patients believed that the business volume generated from these “pill mills” suggested an inappropriate joint endeavor between the physicians and the pharmacies. They also stated that the pharmacies filled prescriptions too early, filled contraindicated prescriptions, and filled prescriptions for substances that would enhance the effects of the painkillers. The Supreme Court noted that most of the patients admitted to engaging in criminal activity related to their addictions and that their addictions predated treatment sought at the medical center. Due to these admissions, the pharmacies and providers argued that the patients’ claims should be barred. In some jurisdictions, the “wrongful conduct rule” prohibits  victims from recovering if they contributed to his own injuries through unlawful conduct. The Supreme Court explicitly declined to adopt this doctrine and held fast to the comparative fault system. The court noted that the current system  allows a jury to choose which conduct to discourage.

Presidential attention

Since this decision was issued, President Obama visited West Virginia in an effort to draw attention to the efforts to combat opiate abuse in October 2015. He spoke in a community forum about the need to better address the problem, and noted that there is a bipartisan shift away from pursuing incarceration. A concerned citizen highlighted the lack of rehabilitation options in the state, pointing out that his daughter had to seek help in Michigan.