Opioid Addiction

Updated at 5:45 p.m. ET

In less than a week, a landmark battle over who bears responsibility for the U.S. opioid crisis will begin in federal court.

The case involves thousands of plaintiffs at virtually every level of government and defendants from every link in the chain of opioid drug production — from major multinational corporations such as Johnson & Johnson and CVS, right down to individual doctors. And on Oct. 21, the first trial is set to kick off before a judge in the Northern District of Ohio.

There's no doubt that opioids have been massively overprescribed in U.S. In the haste to address the epidemic, there's been pressure on doctors to reduce prescriptions of these drugs — and in fact prescriptions are declining. But along the way, some chronic pain patients have been forced to rapidly taper or discontinue the drugs altogether.

Now, the U.S. Department of Health and Human Services has a new message for doctors: Abrupt changes to a patient's opioid prescription could harm them.

Editor's note: To protect the anonymity of the children in this story, we are not using their names.

Children are often called the hidden casualties of the opioid epidemic. They carry a lot of secrets and shame.

Map of a ski mountain.
Howard Weiss-Tisman / VPR File

Last week, Vail Resorts significantly expanded its reach into the ski industry in the Northeast and Midwest, by closing on a purchase of Peak Resorts. The deal also benefited members of the Sackler family, owners of Purdue Pharma which makes OxyContin.

Purdue Pharma, the maker of OxyContin, filed for Chapter 11 bankruptcy protection Sunday night, just days after striking a settlement with more than 2,000 local governments over its alleged role in creating and sustaining the deadly opioid crisis.

The next generation of doctors will start their careers at a time when physicians are feeling pressure to limit prescriptions for opioid painkillers.

Yet every day, they'll face patients who are hurting from injuries, surgical procedures or disease. Around 20% of adults in the U.S. live with chronic pain.

Updated at 8 p.m. ET

The family that owns Purdue Pharma, maker of Oxycontin, has agreed to give up "the entire value" of the privately owned firm to settle claims that Purdue played a central role in the nation's deadly opioid epidemic.

That's according to a spokesperson for the firm, who detailed the Sackler family's offer in an email sent to NPR on Monday.

"Additionally, the Sacklers have offered $3 billion in cash as part of the global resolution," wrote Josephine Martin, Purdue Pharma's head of corporate affairs and communications.

Peter Grinspoon got addicted to Vicodin in medical school, and still had an opioid addiction five years into practice as a primary care physician.

Then, in February 2005, he got caught.

Left, an opium poppy after the opium-rich latex has been harvested from the flower's capsule. Right, co-authors David Blistein and Dr. John Halpern's new book on the history of opium.
Photo: Laughlin Elkind via Wikimedia Creative Commons / Cover: Hachette Books, courtesy

The opioid crisis claims thousands of lives every year in the United States. Distinctions between oxycontin, heroin and synthetic opioids like fentanyl are sadly all too common to Vermonters. We're talking with the authors of a new book, Opium: How An Ancient Flower Shaped And Poisoned Our World, about what the history of the drug can tell us about today's addiction and overdose crisis.

A man in a blue tie.
Elodie Reed / VPR file

The Vermont Health Department is getting a three-year, $9.5 million grant from the Centers for Disease Control to improve its tracking of opioid overdoses.

Updated at 7:04 p.m. ET

An Oklahoma judge has ruled that drugmaker Johnson & Johnson helped ignite the state's opioid crisis by deceptively marketing painkillers, and must pay $572 million to the state.

Oklahoma sought $17.5 billion, blaming Johnson & Johnson for fueling the crisis that has claimed the lives of more than 6,000 people in the state.

A woman holds a copy of the weekly newspaper Seven Days featuring a story in the "Hooked" series on opioids and addiction.
Matthew Smith / VPR

The stigma surrounding opioid addiction is pervasive. Many grappling with it, and even those years into their recovery, often struggle to talk with their doctors or families about it. But when addiction and recovery intersect with pregnancy, that stigma is only amplified. 

Jason was hallucinating. He was withdrawing from drugs at an addiction treatment center near Indianapolis, and he had hardly slept for several days.

"He was reaching for things, and he was talking to Bill Gates and he was talking to somebody else I'm just certain he hasn't met," his mother, Cheryl, says. She remembers finding Jason lying on the floor of the treatment center in late 2016. "I would just bring him blankets because they didn't have beds or anything."

Louis Morano knows what he needs, and he knows where to get it.

Morano, 29, has done seven stints in rehab for opioid addiction in the past 15 years. So, he has come to a mobile medical clinic parked on a corner of Philadelphia's Kensington neighborhood, in the geographical heart of the city's overdose crisis. People call the mobile clinic the "bupe bus."

Five people stand around a podium.
Elodie Reed / VPR

The University of Vermont will receive a new federal grant to start the UVM Center on Rural Addiction.

An OxyContin bottle with pills arranged around it.
Toby Talbot / Associated Press File

Nearly 119.5 million pills were sold in bulk in Vermont by opioid manufacturers and distributors from 2006 through 2012. That's the finding from Seven Days, which analyzed data made public by the U.S. Drug Enforcement Administration.

My Heart Still Beats logo. Text says VPR My Heart Still Beats, a project of Writers for Recovery and has illustrations of six people.
Janelle Sing

What role does storytelling play in addiction and recovery? 

The number of cases of children entering the foster care system due to parental drug use has more than doubled since 2000, according to research published this week in JAMA Pediatrics.

Top officials from 13 states are joining Philadelphia in urging a federal court to allow a site to open where people can inject illegal opioids under medical supervision, the latest escalation in a legal battle with the Justice Department that may determine whether such facilities, known as supervised injection sites, can start to operate in America.

Brenda Siegel and Shawn O'Dell seated on an outdoor bench in Brattleboro, Vermont
Peter Hirschfeld / VPR

State officials say a dramatic increase in treatment services for opioid use disorder has mostly eliminated waitlists for Vermonters trying to get into recovery, but some active opioid users in Brattleboro say they continue to face barriers to care.