A doctor and opioid researcher told the judge companies like Johnson & Johnson did everything in their power to influence doctors to prescribe opioids, even when patients didn't necessarily need them.
Dr. Andrew Kolodny said he and other doctors were misled on all sides about how harmful the drug actually is.
He said doctors weren't only influenced by sales representatives to prescribe more painkillers; he said Johnson & Johnson funded educational courses and paid trusted physicians to spread the good word about opioid products.
Kolodny said doctors were told opioids were a gift from mother nature and should be used to end the suffering of patients who are debilitated by chronic pain.
"Doctors would have been less gullible if it was just the sales reps," he said. But it wasn't just the sales reps. We were hearing it from pain specialists, imminent in the field of pain medicine. We were hearing it from our professional societies, we were hearing it from hospitals, we were hearing it from state medical boards."
Dr. Kolodny also told the judge that even the "perfect pain patient" would become physiologically dependent on painkillers if they took them long enough.
He said Johnson & Johnson relied on a "half-truth" to doctors, saying addiction is rare if taken as prescribed. Kolodny said the company didn't tell doctors that physiological dependence will happen even if taken as prescribed.
Kolodny said if you use opioids for any length of time, you'll have a hard time stopping, dealing with withdrawal symptoms like insomnia, anxiety, and depression.
"One of the more distressing symptoms, when people are going into withdrawal, is anxiety, severe anxiety. It feels like a panic attack," he said. "If you've ever wondered why people do such desperate things to maintain the opioid supply once they've become physiologically dependent, it's not that they're afraid to feel like they have the flu."
Kolodny said it was clear to medical professionals that the increase in prescribing created a public health problem. He said despite that, Johnson & Johnson did everything they could to encourage doctors to keep prescribing their drugs.