A lawsuit filed in Manitoba is seeking more than $1 billion in damages to hold pharmaceutical companies responsible for what's been called a public health crisis linked to opioid drugs.
The proposed class-action lawsuit, filed with Manitoba Court of Queen's Bench by a Toronto law firm on Dec. 30, says tens of thousands of Canadians are estimated to have died of opioid overdoses in the past two decades.
The statement of claim alleges drug manufacturers failed to warn medical professionals and patients about the risks and dangers associated with opioid use, such as overdose, addiction and death.
It lists dozens of drugs in the opioid category, including fentanyl, methadone, morphine, hydromorphone, opium, oxycodone, oxymorphone, codeine and Percocet.
The lawsuit seeks more than $1.1 billion in damages for people who have suffered harm from opioid drug prescriptions from 1996 to the present. Family members of those patients, and heirs to any who have died, could also potentially qualify as plaintiffs.
Defendants in the lawsuit are 35 companies that manufacture, market, distribute and sell opioids in Canada.
Marketing targeted doctors, students: claim
The lawsuit alleges the drug manufacturers "targeted physicians and health-care practitioners with false and misleading statements regarding the safety and efficacy of utilizing opioid drugs for long-term, chronic pain."
The marketing efforts particularly targeted family doctors and medical students "who frequently saw patients with chronic pain conditions and who did not have the level of training to verify whether the … claims concerning the safe and effective nature of the drugs were correct," the lawsuit says.
It alleges pharmaceutical sales representatives known as "detailers" met personally with doctors.
"These direct-to-physician visits by drug representatives are well-recognized as highly effective tools for increasing prescriptions for any drug," the court document says.
Drug manufacturers enlisted doctors to become "key opinion leaders" to bring pro-opioid positions to other health-care professionals, the lawsuit alleges.
Those key opinion leaders "would provide the false appearance of unbiased and reliable support for increased use of opioids," it says.
Alleged 'front groups' created to support opioid use
The lawsuit also alleges the drug manufacturers created, funded, and controlled various think tanks and patient advocacy groups to encourage physicians to use opioids for untreated pain.
The suit says those "front groups" produced "education materials containing information that appeared independent and reliable, but was in fact false and misleading."
The drug manufacturers knew or ought to have known their claims about the risks and benefits of opioids were not supported by scientific evidence, the claim says.
Where front groups and opinion leaders "pointed to scientific evidence allegedly supporting their claims of efficacy and safety, the authors were invariably industry-paid [key opinion leaders]," the lawsuit alleges.
The allegations have not been proven in court and the defendants have yet to file statements of defence.
CBC News reached out to many of the corporate defendants. Some indicated they would not comment while the case is before the court.
Claims 'without merit': defendant
Sandoz Canada Inc., one of the defendants, acknowledged the lawsuit in an email to CBC.
"We believe that these claims are without merit and will vigorously contest them," the pharmaceutical company's statement said, adding it will continue "providing high-quality, affordable medicines to patients, and conducting business with integrity."
The representative plaintiff in the lawsuit is an Ontario doctor, Darryl Gebien, who had an opioid addiction. Gebien was prescribed Percocet after he suffered a ligament injury in his thumb, the lawsuit says.
His addiction to the drug had a significant impact on his life, the claim says, as he lost his job, his licence to practise medicine and custody of his children.
He also faced criminal charges related to fentanyl trafficking that netted a two-year jail term.
The claim seeks a court order certifying the lawsuit as a class action and also seeks an accounting of the profits each defendant company earned from the sale of opioids since 1996.
The law firm that filed the Manitoba claim also filed a similar lawsuit in Ontario in May 2019, with Gebien as the representative plaintiff.
The British Columbia government launched a class-action lawsuit in 2018 seeking damages from drug companies to recover millions of dollars in opioid-related health care costs incurred by the provincial government.
Since then, all other Canadian provinces and territories, plus the federal government, have joined B.C.'s court action, a spokesperson for the B.C. Ministry of the Attorney General says.
The claim filed at Court of Queen's Bench last month says Manitoba has a "real and substantial connection" with the lawsuit because the defendant companies derive substantial revenue from the sales of their products in the province.
In addition, it says opioids were advertised in Manitoba and people were administered the products here and suffered resulting damages.
Pandemic compounded crisis: Health Canada
Health Canada says the COVID-19 pandemic has tragically compounded the opioid crisis.
While the federal government is not a party to the Manitoba lawsuit, data from Health Canada shows 1,720 deaths from apparent opioid toxicity in the three months from April to June 2021— approximately 19 deaths per day.
The federal data includes 24,626 opioid toxicity deaths between January 2016 and June 2021.
Health Canada now has a strategy to "limit the marketing of opioids directed at health-care professionals," spokesperson Charlaine Sleiman said in an email to CBC.
Opioid information directed at health-care professionals needs pre-clearance before it can be used, she wrote, and needs to convey the benefits and risks of opioids in a balanced way.
Health Canada launched a web platform "aimed at health-care professionals to encourage them to report any advertising that they feel is false or misleading," she said.