Weekly Mass Torts Bulletin 2023-October-2

The Weld County Health Department is one of the recipients of a recent national landmark settlement involving prescription opioid manufacturers and distributors.

The funding will be channeled into prevention programs aimed at reducing the high number of deaths associated with opioids in the county. Approximately one person per week loses their life due to opioid-related issues and overdoses.

Weld County's Department of Public Health, in conjunction with a regional opioid abatement county, will be allocated $8.8 million to combat the ongoing epidemic that has had a profound impact locally. These funds will be directed to organizations that can support the efforts of local health officials in preventing harm from opioid abuse.

The regional council director and chairman view this as a significant opportunity to address the opioid crisis at the grassroots level and encourage all eligible organizations to apply for these funds. The regional council, comprised 14 members, including elected officials, law enforcement personnel, public health experts, human services professionals, and others, will determine how to allocate the millions of dollars over the next 18 years. This funding is part of a larger $520 million settlement, and it's not the first time such settlement money has been directed to local government initiatives; a similar settlement took place in 2019.

The regional council's focus is on seeking proposals from local organizations with programs that emphasize recovery, treatment, prevention, and education to save lives. They aim to address three key areas: opioid use prevention, treatment, and education. This initiative is in response to a crisis, with 53 Weld County residents losing their lives to opioid prescription and other overdoses in 2022 alone, which equates to approximately one death per week. Over the past decade, the state has reported around 6,000 overdose deaths.

Applications are open to non-profit organizations, community-based groups, healthcare institutions, and schools. However, applicants must align with one of the three focus areas: prevention, education, or treatment related to opioid drug use, according to the regional council director. The application deadline is October 11, and the initial funding starts at approximately $30,000.

While the opioid award will increase the health department's budget, it's important to note that these funds will be reinvested directly into the community, as explained by the chairman. The county has currently funded only one full-time position: a health educator responsible for coordinating the efforts of the opioid council and collaborating with schools and community groups on drug use prevention.

A recent study has established a crucial link between a specific protein released in response to asbestos exposure and the development of mesothelioma, shedding light on the long-sought-after mechanism behind this deadly cancer.

Scientists from the University of Hawaii Cancer Center have identified the protein HMGB1 as the initiator of the inflammatory process that ultimately results in the onset of mesothelioma. These findings, published in the Proceedings of the National Academy of Sciences of the U.S., signify a significant breakthrough in understanding the cause of this devastating cancer.

The study's primary focus was pinpointing the main cell type responsible for the inflammation triggered by asbestos exposure. To do this, researchers engineered genetically modified mice with controlled HMGB1 expression in various cell types and exposed them to asbestos.

The results indicated that mesothelial cells, which make up the lining of the abdomen, chest, and internal organs, release HMGB1 during the initial stages of inflammation following asbestos exposure. Subsequently, macrophages, which are inflammatory cells, also release this protein. The data suggests that the release of HMGB1 prompts the production of another protein, TNFa, or tumor necrosis factor. Previous research had already linked TNFa to the body's inflammatory response and certain autoimmune diseases.

The combination of these two proteins following asbestos exposure initiates a chronic inflammatory process that promotes the development of mesothelioma, as concluded by the researchers.

The use of asbestos, a naturally occurring fibrous mineral resistant to heat and corrosion, was once widespread in the construction industry and various commercial products like automotive brakes, insulation, wallboard materials, and fireproofing materials.

Mesothelioma is a rare and aggressive form of cancer that affects the thin tissue lining the chest and abdomen. It leads to approximately 3,200 deaths annually in the United States, and most individuals diagnosed with mesothelioma survive for only 18 to 31 months.

The sole known cause of mesothelioma is prior exposure to asbestos, leading to its banning in most applications in 1972. However, it has taken decades for mesothelioma rates to decline following the ban due to the lengthy latency period before diagnosis.

This invasive cancer often remains asymptomatic for many years, sometimes even decades, making it typically diagnosed at an advanced stage and resulting in a limited life expectancy.

Mesothelioma lawsuits are a significant part of the largest mass tort in U.S. history, with over 600,000 people filing cases against more than 6,000 defendants due to injuries stemming from asbestos inhalation. In addition to individuals directly exposed to asbestos, a growing number of recent lawsuits involve second-hand exposure, where individuals inhaled fibers carried on their parents' clothing or hair during childhood.

Researchers are hopeful that the findings from this new study will pave the way for the development of more effective preventive and therapeutic strategies for those at risk of developing mesothelioma due to asbestos exposure.

Researchers from the University of California-Los Angeles have reported a dramatic increase of over 50 times in U.S. overdose deaths involving a combination of fentanyl and stimulants over the past 13 years.

Fentanyl, an incredibly potent synthetic opioid, is approximately 100 times more potent than morphine and 50 times more potent than heroin. While it is technically approved by the U.S. Food and Drug Administration (FDA) for medical use in specific situations to manage pain and serve as an anesthetic, its illicit use on the streets has exacerbated and worsened the ongoing opioid crisis in the United States.

In 2010, authorities linked 235 deaths (0.6%) to a mix of fentanyl and stimulants. By 2021, this number had surged to 34,429 deaths (32.2%).

By 2021, stimulants like cocaine and methamphetamine had become the most prevalent drugs found in fentanyl-related overdose cases in every single U.S. state. This troubling increase in deaths connected to the combination of fentanyl and stimulants marks the fourth wave of the long-standing opioid overdose crisis in America, according to researchers.

The opioid crisis in the United States has persisted for nearly two decades, claiming the lives of over half a million Americans. The remarkable endurance and longevity of this crisis are initially astonishing, but it is essential to recognize that opioid-related overdoses have unfolded in distinct waves since the early 2000s.

Beginning in the early 2000s, there was a surge in deaths linked to prescription opioids (wave 1). By 2010, fatal overdoses involving heroin were skyrocketing (wave 2). By 2013, fentanyl overdoses began to dominate the reported drug-related fatalities (wave 3). Just a few years later, in 2015, deaths attributed to fentanyl overdoses in combination with stimulants began to increase significantly, and this trend continues to grow today (wave 4).

It is crucial to note that individuals who consume multiple substances in a short timeframe are at a higher risk of overdose. Moreover, many substances mixed with fentanyl do not respond to naloxone, which is considered the antidote to opioid overdose.

Researchers also observe that fentanyl and stimulant overdose deaths disproportionately affect racial and ethnic minority communities in the United States, particularly African Americans and Native Americans. For instance, in 2021, the rate of stimulant involvement in fentanyl overdose deaths was 73 percent among non-Hispanic Black or African American women aged 65 to 74 in the western United States. The same prevalence was 69 percent among Black or African-American men aged 55 to 65 living in the same region. In 2021, the overall prevalence in the entire U.S. population was 49 percent.

Geographical patterns also appear to play a role in this issue. In the northeastern United States, fentanyl is typically mixed with cocaine, while in the southern and western U.S., it is more commonly combined with a form of methamphetamine.

The Tennessee Attorney General has announced a $44.5 million settlement with K-VA-T Food Stores, commonly known as Food City, in connection with their involvement in the opioid crisis.

According to the Attorney General's Office, a significant portion of this settlement will be allocated to Tennessee's Opioid Abatement Fund, which will support local initiatives aimed at addressing the opioid epidemic.

Apart from the financial settlement, Food City has also committed to ensuring future compliance by providing additional training to their pharmacy staff, updating the prescription-validation process, and closely monitoring and reporting any suspicious activities related to opioids. Additionally, the company will create dedicated employment opportunities for individuals in Tennessee who are recovering from opioid addiction.

The Attorney General emphasized the importance of holding all parties accountable for their contributions to the opioid crisis and commended the relentless efforts of the Consumer Protection Division in pursuing justice in this case. The settlement not only imposes a substantial cost on Food City for past misconduct but also provides crucial resources to save lives and protect families while allowing the company to refocus on serving its customers and supporting Tennessee communities.

K-VA-T Food Stores issued a statement in response to the settlement, stating that it concludes two opioid-related cases in Knox County and Sevier County. They emphasized that these cases are just a fraction of the many similar cases nationwide that target manufacturers, distributors, and retailers of prescription opioids. The allegations in these cases primarily pertain to events from over a decade ago, and K-VA-T has consistently denied any wrongdoing. The settlement agreement does not constitute an admission of liability or wrongdoing and is seen by the company as a mutually beneficial resolution that will contribute to opioid-related programs established through previous settlements with national retailers and distributors.

The company's statement also expressed its commitment to supporting local drug rehabilitation centers and their efforts to assist individuals in recovery and help them lead more productive lives.

In early 2021, a case was filed in the Knox County Circuit Court alleging that certain Food City pharmacies had unlawfully sold tens of millions of prescription opioids for more than a decade. At the time, Food City's CEO had stated that the lawsuit was based on false information.

Recently, Kroger reached a national agreement of $1.4 billion to be paid out over 11 years, with 33 states and some Native American tribes eligible to receive funds as part of their own settlement related to the opioid crisis.