Lawyer Paul Farrell Jr. ’94 filed one of the first public nuisance lawsuits against opioid manufacturers and distributors in 2016. His client? His hometown of Huntington, West Virginia, which was devastated by the opioid epidemic. Farrell has since played a key role in the nationwide legal effort to hold manufacturers accountable, resulting in changes to prescription policy and practice, and the awarding of more than $60 billion in restitution funds that will pay for addiction treatment and prevention programs in affected communities.
How did you first encounter the opioid epidemic?
My father, who was a judge, commented that there were so many babies being born addicted to opioids, he couldn’t find family members who could pass a drug test to keep the baby, and we were running out of foster care. A nonprofit center opened up called Lily’s Place that was keeping newborn babies who had nowhere to go and were still weaning off of opioids.
We had to open up a new wing of our neonatal intensive care unit to address nothing but babies born addicted to opioids. We had volunteers who would come in shifts 24 hours a day and rock these screaming babies in a private nursery as they went through withdrawal.
So it’s one of those things that weighs really, really heavy on my hometown. It got to the point where you noticed it not just in the alleyways, but in daily life.
In November 2016, my mother asked me what I would do to stop it. She had raised me to fight for those who couldn’t fight for themselves, and this was a fight I needed to do something about, she told me. That’s when I decided that I would.
Where did you go from there?
Based on my background in government — I was a government major at Notre Dame — I knew there were certain things that our attorneys general could and could not do. I went to the office and looked up the West Virginia code.
I just started flipping through to try to understand what authority counties had to fight something like this. I knew we couldn’t arrest our way out of the problem or rely on the federal or state government; local problems require local solutions. And as I’m flipping through this code book, I saw that the West Virginia legislature authorizes the county commissions to eliminate hazards to public health and safety.
And so I started thinking if the Exxon Valdez crashed into the shores of Huntington, West Virginia, and dumped millions of gallons of oil, it’d be a public nuisance and they would have to clean up the mess. Well, the distributors of opioids crashed their delivery trucks into our hometown and dumped millions and millions of pills into our backyard, creating a public health crisis, and now they need to clean it up.
So I began studying the opioid epidemic and filed the first public nuisance case in the country. Then I started signing up the communities up and down Appalachia rivers. And the next thing you know, the opioid epidemic blossomed and turned into a nationwide epidemic. And I got hired by about 800 counties across the country and everybody ended up filing, and all the cases got consolidated into one massive case up in Cleveland, Ohio. I was appointed co-lead of MDL 2804, the National Prescription Opiate Litigation.
What were some of the more dangerous trends you saw?
Well, the thing that is truly startling is that when you look at the places where they sold the most pills, you can look at poverty patterns and see that places where there’s economic vulnerability are exploited the most.
It just makes you sick to your stomach. How can we go to those communities that are the most fragile and dump opium on them?
This isn’t the first opium or opioid crisis, is it?
When Pandora opened the box, the first thing that popped out was opium. Since then, all we have done is figure out how to make it more addictive.
The manufacturers created a false narrative that opium was no longer addictive. So, while the doctors have a large responsibility in this, they’re just one link in the chain. This was a societal failure that started at the manufacturer level.
The American pharmaceutical industry found the most lethal addictive molecule in the opium plant, mass-produced it in the form of a pill, and then convinced doctors to prescribe it for pain. And that’s the ultimate story to all of this — somehow in America, we decided it was OK to give people in pain bottles of opioids and then were shocked when they became addicted.
You know people personally who have dealt with opioid addiction. Given the emotional toll this epidemic has had on families, what have been some of the most challenging aspects of working on these cases?
The thing that bothered me the most was that I was just too late for some of them.
I had a friend named Gary. Well, Gary had a daughter who got addicted to opioids, and I had been helping her as much as I could. She had a newborn baby, and around Christmastime, she was given $20. She said she was going to go out and get cigarettes, and she was gone for two weeks. She left her baby behind. Gary took the hardest stand a parent could take, and in order not to enable her anymore, threw her out. She moved in with her grandfather.
I got a phone call one day from the grandfather who said that she was talking nonsense and that she was not using opioids anymore but was upset. He didn't know what to do with her and asked if I would talk to her. We talked, and I told her that I wanted her to go to rehab. And she cried and agreed to do it. So I had her grandpa drive her down to the local hospital, and he pulled into the little wraparound. She got out the passenger door and took off running. She was gone for a month.
We had an order put out for her to have her involuntarily committed. And so the next time she got arrested, they took her straight to the rehab hospital, and she was there for 30 days and got sober and clean.
She came out on a Sunday, and they had a huge dinner for her. It was the first 30 days she had been clean in three years. On Monday morning, her grandpa found her with a needle in her arm dead in the bathroom. So yeah, I was late.
That's not a unique story when you look at the number of people who have died from opioid overdoses.
How can people who are not lawyers be a part of the solution?
When we look at it from a humanistic standpoint — that these are human beings who are addicted — we have an opportunity to help these people heal.
It takes everybody in the community to come forward and figure out what role they want to play, whether it’s in homelessness, poverty or education. The impact you can have when you decide to make a difference is amazing. It’s not when you sit on your couch, watch it on the news, say, “How sad,” and then change the channel. It’s when you decide that you’re going to be a part of the solution.
Interview by Michelle Cuneo, an associate editor of this magazine. The interview has been edited for length and clarity.