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The Cherokee Nation on Thursday sued several large pharmacy franchises and pharmaceutical distributors over a prescription opioid epidemic that has ravaged its community in recent years.

The lawsuit seeks injunctive relief, civil penalties, compensatory and punitive damages, restitution, and attorneys fees for allegations that include violations of the Cherokee Nation Unfair and Deceptive Practices Act, gross negligence, unfair enrichment, and civil conspiracy, among others.

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According to Cherokee Nation Attorney General Todd Hembree, the defendants, which include CVS, Walgreens, and Wal-Mart, and distributors McKesson Corporation, Cardinal Health, Inc., and AmerisourceBergen, “knowingly or negligently distributed and dispensed prescription opioid drugs within the Cherokee Nation in a manner that foreseeably injured, and continues to injure, the Cherokee Nation and its citizens.”

The lawsuit states:

For years Defendants and their agents have had the ability to substantially reduce the death toll and adverse economic consequences of opioid diversion in the Cherokee Nation—including the deaths of hundreds of Cherokee citizens and expenditures of hundreds of millions of dollars by the Cherokee Nation in dealing with the problem—but the Defendants pursued corporate revenues instead. All the Defendants in this action share responsibility for perpetuating this epidemic.

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According to Hembree, the three distribution companies named in the suit account for up to 90% of drug distribution revenue in the U.S., which in 2015 totaled a staggering $378 billion. Prescription opioids, including oxycodone, hydrocodone, and fentanyl, are classified as Schedule II drugs under the Controlled Substances Act, and their distribution must be tightly regulated.

But all of the companies mentioned have settled similar lawsuits in recent years, either with the Drug Enforcement Administration or other agencies, regarding the failure to track these Schedule II drugs and their use.

The crisis in Oklahoma’s Cherokee Nation has been particularly acute, as it has in other Native American communities.

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According to the lawsuit:

Oklahoma, where the vast majority of Cherokee Nation citizens reside, leads the country in opioid abuse. In recent years, it has ranked number one nationally for nonmedical use of prescription opioids for adults, and it currently ranks as the fifth highest state with drug overdose deaths in the United States. From 2007 to 2012, more overdose deaths in Oklahoma involved hydrocodone or oxycodone than alcohol, methamphetamine, cocaine, heroin and all other illegal drugs combined.


To give an indicator of just how many prescription opioids have flooded Cherokee Nation communities, according to the DEA, over 2.75 billion milligrams of opioids were distributed in Oklahoma in 2015. About 845 million milligrams were distributed in 14 Cherokee Nation counties. That’s about 703 milligrams per citizen, Hembree states. Because not every Cherokee Nation citizen takes these opioids, the actual amount for each individual who does is likely much higher, pointing to what seems to be a clear problem of illegal diversion of the pills.

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In addition to the adults, the Cherokee Nation also has a serious problem with babies being born with Neonatal Abstinence Syndrome. In many of those cases, infants are separated from parents and placed in Cherokee Child Welfare care. Also, Native American women are up to 8.7 times more likely to be diagnosed with opioid dependence or abuse than the next highest ethnicity, the lawsuit states.

Along with creating a health crisis, the prescription opioid epidemic is draining already limited Cherokee resources needed for education, to combat poverty, and to fund other social programs.

As Stat reported, cities and counties across the U.S. have filed similar lawsuits against drug manufacturers and distributors.

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Responding to questions about the latest lawsuit, CVS Health told Stat that it has “stringent policies, procedures and tools to ensure that our pharmacists properly exercise their corresponding responsibility to determine whether a controlled substance prescription was issued for a legitimate medical purpose before filling it.”

Walgreens did not comment.