Arizona Attorney General Mark Brnovich [official profile] filed [press release] an action [text, PDF] in Pima County Superior Court [official website] on Monday alleging that Purdue Pharma [corporate website] continued deceptive and misleading marketing practices to sell opioids in violation of a 2007 court order.

Brnovich filed the application for order to show cause requesting the court to order Purdue Pharma to appear and give reason why they have not violated the court’s prior order. The 2007 order declared that Purdue

a. “shall not make any written or oral claim that is false, misleading or deceptive.”

b. “shall provide ‘fair balance’ statements … including but not limited to statements regarding [oxycodone]’s potential for abuse, addiction, or physical dependence …

c. “shall not make misrepresentations with respect to [oxycodone]’s potential for abuse, addiction, or physical dependence …”

d. “shall not misrepresent the existence, non-existence, or findings of any medical or scientific evidence …” relating to oxycodone.

e. shall in “All material used in promoting [oxycodone] … contain only information that is truthful, balanced, accurately communicated, and not minimize the risk of abuse, addiction or physical dependence …”

Brnovich brought forth four separate theories as to how Purdue violated the court order. First, he alleged that Purdue falsely advertised the potency of its product as providing relief for 12 hours and in practice, the period of relief was less and caused patients to use more of the product. Second, Brnovich alleged that Purdue engaged in deceptive practices by claiming oxycodone was safer than has been proven by scientific evidence. Part of this claim involves the advertised 12-hour relief period that Purdue allegedly used to claim that the product was less likely to be abused due to that relief period. Another part involves Purdue’s claim in a publication it sponsors, Treatment Options: A Guide for People Living with Pain, that claims opioids have “no ceiling dose” contrary to studies showing that higher doses are linked to higher risk of death. Third, Brnovich alleges that Purdue failed to adequately inform providers of the side effects of the drug, instead promoting its benefits in an unbalanced way. Lastly, Brnovich alleges that Purdue deceptively deemphasized the risk of opioid addiction by describing that potential “signs of addiction did not actually indicate addiction, and could actually indicate a need for more opioids.”

If the court rules against Purdue, the court could order the company to pay civil penalties up to $25,000 per violation.

The abuse of opioids is an epidemic in the US with the Department of Justice [official website] recently announcing an amendment [JURIST report] to the Federal Register that will provide the Drug Enforcement Administration [official website] with more control in the diversion of opioids.