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r n.j Lt} N >z tO (U a hi Oa cD 0 n.j U, to N t cJ C tO C (U U x Is tO (U (U a Prescribed Opioids Codeine (only available in generic f o r m ) 4.. F e n t a n y l (Actiq, D u r a g

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  1. r n.j Lt} N >z — tO (U a hi Oa cD 0 n.j U, to N t cJ C tO C (U U x Is tO (U (U a

  2. Prescribed Opioids • Codeine (only available in generic f o r m ) 4.. • F e n t a n y l (Actiq, D u r a g e s i c , Fentora) • Hydrocodone (Hysingla ER, Zohydro ER) • H y d r o c o d o n e / a c e t a m (Lorcet, Lortab, Norco, Vicodin) i n o p h e n / • H y d r o m o r p h o n e (Diiaudid, Exalgo) • Meperidine (Demerol) • M e t h a d o n e (Dolophine, Methadose) • Morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR) • Oxycodone (OxyContin, Oxecta, Roxicodone) • Oxycodone and acetaminophen (Percocet, Endocet, Roxicet) 4 • O x y c o d o n e a n d naloxone (Targiniq ER) t I . FERRER POIROT FEARS NACHAWATI The Opioid Epidemic WANS BRO UGH I. A W F I Ii M ill,, CnLtI n,i,nII, 2

  3. Opioid Addiction I m p a c t By t h e _ N u m b e r s opioid Drug Overdose 6 O u t estimate of the 650,000 $ 7 8 . 5 prescriptions deaths involve an economic burden of of 10 opioid. dispensed daily B i l l i o n the epidemic to the country in 2013. About one third is Americans have $28.9 from higher health died from drug people daily 500,000 care and addiction 580 initiate heroin overdose in the Billion treatment costs last 17 years. use Of non-working people die every day $20 in lost productivity men in the prime 7S 31% from overdose in nonfatal cases. of their lives are B i l l i o n taking opioids Source: National center for Injury Prevention and Control, CDC ![!REI POIROT FEARS NACFL4WATI The Oplaid Epidemic WAHSBRDUGH I. A W F I P IA ii lb.., I.,HI. 3

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  6. ____ _ ___ _ _ ___________________________________ _______________ ______________ _________ _ _ _ _ ; C f l ’ n i -C— a 0 r Accidenwi O D s p e r 1 0 0 . 0 0 0 %J 0 C C h - C - a X a a -J -. -c ‘4 — Og— C-.. a U ( S c 1 O I t .4c:dzr r o a -______________ d II *1 -a a ri-I * : C.’

  7. __________ —v cc deaths per 100,000 10 15 20 25 30 I I I I I Ni 0 o C I I I I I I N C- / o g (3, I ID / ‘I) Ni 0 / -& o n i / I 0 • — • - 0 — z a N e . Ct 0 0. 0 — -k 0 t — —---— I e e — deaths per 100.000 200 250 300 350 400 450 I I to. — CD — 0 ci, B C -t CD I) 0 2 H1 tij tJ1 P3 0 Ui t..a > C > C corn z u m co I -J

  8. Oxycodone consumption, 2015 I n kilograms 60.000 - 20. 000 So,ncc: I,,wr,j,nionai A,,rouc.c C o n , m I horny. counesv o f — ——— 0 Unircrsitv o f JJ’tcconsin Pain — a n d Pniin S t u d i e s G m u p _e ‘? S C? FERR [ I ROT I P01 FEARS NACHAWATI The Opioid Epidemic W A N S E R O U C K ‘dli, Qinel ‘Liii Iii. t A W F I P M S

  9. W o r l d O x c o d o n C e o n s u m p t i o n 1 9 8 0 2 0 1 5 - 250 - 200 -e Europe ( E U R O ) o x y c o d o n e U S A o x y c o d o n e . 5 0 - a- eape,->c...c.o Sources: I n t e r n a t i o n a l N a r c o t i c s Control B o a r W o r l Organization d ; d Health p o p u data l a t i o n By: Pain & P o l i c y S t u d i e s Otoup. University Wisconsin/WHO o f C o l l a b o r a t i n g C e n t e r . 2 0 1 8 F E R R E R PUIROT PEARS NACHAWATI The Opioid Epidemic WANSRbUGII I. A W P M e..h,h A F I N. 9

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  15. Lfl (1) a 4-J 0) CD C CD U) I 0 .1 4-’ a) e I a I S S 0 U) S I 4-’ S U) 13 z 4- 0 Ci in vi us w 0 UI I- o oo a. Cfla LaJ I_I La— a

  16. Its Getting_Better, Right? Jonathan N o v a k , p a r t of our litigation team w a s f e a t u r e d o n b o t h 60 M s and i n u t e a r e c e n t S e n a t e Hearing explained t h a t a t t h e height of the DEA’s efforts enforce existing regulations, they were s h u t down. P o l i t i c a l pressure from o n high e n d e d DEA enforcement. • T h e Marino Act finalized t h e efforts o n b e h a l f o f drug t h e m a n u f a c t u r e r s and distributors by r e m o v i n g the DEA’s t e e t h , e f f e c t i v e l y stripping t h e DEA of their enforcement ability. • Leaving only t h e Civil justice System to hold t h e m a c c o u n t a b l e FERRER POIROT FEARS NACHAWATI The Opioid Epidemic WANSBROUGH LAW FIRM O.•J.I Ii..iII. lbn,, 16

  17. N — 4_i C 0 .2 D 4-’ L U 4-’ <or d1 S Ucr crew, S tu S U, S F S . .4_i cj 5 Ln -C —r u cuD t Q4J%_4J D uun-’c co suG) C 0 L U C (0 -J 8 Ut) 6b o D ., - z U E C -c tn 5 50 D CD a U a. a. cc: taJ . . . . . . . B B B L1

  18. Damages — — — — — — • Actual D a m a g e s • Cost of indigent care • Cost of any County supported drug relief • L a w enforcement cost, jails • L i t i g a t i o n cost • Punitive D a m a g e s • E x e m p l a r y d a m a g e s ( g r o s s n e g l i g e n c e ) • T r e b l e d a m a g e s • E q u i t a b l e relief ( a n d t h e costs o f t h e equitable relief) • Injunction • Abatement • Attorney’s f e e s FERRER POIROT FEARS NACHAWATI The Opioid Epidemic WA N S BR 0 (JO H I A W F I A M—-— Jk. OIIkJ huT 18

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