Closing arguments are set Monday in Cleveland in the lengthy opioids federal lawsuit brought by Trumbull and Lake counties against three major pharmacy chains.

Lawyers for the counties and the chains were last in court on Tuesday, agreeing on final exhibits for the jury, which will be presented in flash drive form to the court Monday prior to final arguments.

After the closings, U.S. Judge Daniel Polster of the Northern Ohio District will give jurors their charge.

Throughout the six-week trial, defense lawyers have claimed the plaintiffs have failed to show that the pharmacy chains have been an ongoing public nuisance by distributing prescription opioids.

To counter that argument, the lawyers for Trumbull and Lake counties have written in a lengthy brief that they have produced evidence that showed “defendants engaged in misconduct with respect to those prescription medications.” And the plaintiffs argue this nuisance claim is not bound by a two-year statute of limitations.

JURORS’ ROLE

Jurors have to decide if the plaintiffs have proven that the chains’ intentional or unlawful conduct or omission has risen to the level of being a public nuisance.

A plaintiff’s brief states that CVS, Walmart and Walgreens “knew that failing to employ sufficient dispensing practices would cause significant diversion, leading to opioid abuse and related harms” in Trumbull and Lake counties.

From January 2006 through April 2018, statistics in the brief show Walmart dispensed an average of 1.97 dosage units of oxycodone and hydrocodone per year to every man, woman and child in Trumbull County. At its peak in 2016, Walmart dispensed an average of 3.32 dosage units of oxycodone and hydrocodone that year to every man, woman and child in Trumbull County.

Defense lawyers also say the counties’ case rises and falls with the testimony of legal experts such as Drs. Caleb Alexander, Katherine Keyes, Anna Lembke and Craig McCann. The pharmacy chains’ lawyers claim that without these statements, the plaintiffs’ case lacks legal standing.

Dr. Alexander is professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health and founding director of its Center for Drug Safety and Effectiveness.

Dr. Keyes is an associate professor of epidemiology at Columbia University; Dr. Lembke is a California psychiatrist who teaches at Stanford University and McCann is a former academic, an economist and consultant for the pharmacy industry.

The lawyers for the chains had tried to bar the jury from hearing this expert testimony but Polster ruled otherwise.

Among others testifying for the plaintiffs were Capt. Tony Villanueva, commander of the Trumbull sheriff’s TAG drug abuse task force, and April Caraway, executive director of the Trumbull County Mental Health and Recovery Board.

In earlier depositions, Villanueva and Caraway both mentioned that prescription opioids serve as “gateways” for those addicted to get into harsher, street-level drugs such as heroin and fentanyl. Defense lawyers, however, successfully kept that line of testimony away from the jurors.

Prior to the trial, the Rite Aid chain settled with the two counties for $1.5 million.

As the plaintiffs rested their case at trial, lawyers with Giant Eagle announced they have settled with the two counties, but terms of the agreement were not disclosed.

gvogrin@tribtoday.com