Weekly Mass Torts Bulletin 2024-June-3

Toronto Reports 523 Opioid Overdose Deaths Last Year

According to preliminary data from Toronto Public Health, there were 523 opioid toxicity deaths in the city in 2023, marking a 74% increase from 2019 when 301 deaths were recorded due to toxic drugs.

Of the 523 drug-related deaths in 2023, 427 have been classified as accidental. Almost half of these individuals were aged 25 to 44, with 54% living in private residences and 39% dying at home. The 2023 figures show a slight increase from 2022, which saw 510 deaths from unregulated drugs. Public Health Ontario and the Office of the Chief Coroner for Ontario confirmed 507 of those deaths, with three considered probable.

The peak of the pandemic in 2021 saw a record-breaking 591 confirmed drug toxicity deaths in Toronto. The city's Medical Officer of Health described the ongoing drug toxicity epidemic as a devastating human tragedy that necessitates a compassionate response. Toronto’s unregulated drug supply has become increasingly toxic, contaminated with unexpected and dangerous substances.

Toronto Public Health has issued four drug alerts this year to inform drug users, harm reduction organizations, and public health units about potent toxic substances in the unregulated drug supply and rising suspected overdoses.

One key response to this crisis is the implementation of supervised consumption services (SCS), which provide clinical spaces where individuals can use drugs under the supervision of trained health professionals. Toronto currently has ten such sites.

Evidence indicates that SCSs save lives, connect people to social services, and serve as pathways to treatment. Toronto Public Health advocates for greater access to a comprehensive range of evidence-based healthcare services, including prevention, treatment, and harm reduction supports. The health unit remains committed to exploring collaborative solutions to this urgent public health issue.

Hawaii Orders Drugmakers to Pay $916M in Plavix Lawsuit

A Hawaii court has mandated that the manufacturers and distributors of the blood thinner Plavix pay the state $916 million for failing to disclose the medication's efficacy and safety, according to the state attorney general.

The judgment targets Bristol Myers Squibb Company and three U.S. subsidiaries of the French pharmaceutical company Sanofi. Both Bristol Myers Squibb and Sanofi expressed their disagreement with the penalty and plan to appeal.

First Circuit Court Judge James Ashford found that around 30% of patients, particularly non-Caucasians, might have a "diminished response" to Plavix, yet the companies did not update the drug's label to reflect this risk. The attorney general stated that the companies acted in bad faith by marketing a product that could have severe consequences for Hawaiian patients despite knowing it would be ineffective for a significant portion of the population.

Hawaii filed the lawsuit in 2014, noting that more than 1 million Plavix prescriptions had been issued in the state since the drug's introduction in 1998. Hawaii is the fifth state to sue over Plavix's marketing practices, following Louisiana, Mississippi, West Virginia, and California.

In a joint emailed statement, the companies maintained that a substantial body of scientific evidence supports Plavix's safety and efficacy regardless of a patient's race and genetics. They described the penalties as "unwarranted and out of proportion." The companies also pointed out that Hawaii's case is an outlier, as they have successfully defended against similar litigation in other states.

The companies emphasized that Plavix has been a critical treatment for millions of cardiovascular patients worldwide for over two decades. They noted that the drug is endorsed as a first-line therapy by leading treatment guidelines globally and remains the standard of care.