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Home / Opioid Crisis / “Purdue Pharma Legacy” Big Pharma’s Opiates Have Taken A Toll On American Children

“Purdue Pharma Legacy” Big Pharma’s Opiates Have Taken A Toll On American Children

Categories: Opioid Crisis Tags: opioid crisis, purdue pharmaFebruary 18, 2020 by Mass Tort News Leave a Comment

Opioid Rx Industry and a Model of “Profits Before Patients” Results: Impact on American Children?

Snapshot: In West Virginia, home of the highest overdose rates in the nation, the foster population has increased by 42 percent since 2014, with the current foster care numbers at over 7,200 children in state custody. Although the exact numbers of kids who are now without families due to the opioid crisis and Big Pharma bad conduct is not known, rest assured that in West Virginia, the correlation of foster kids and the opioid crisis is intimately linked and the results are catastrophic. With a population of just over 1.8 million people, the numbers are very skewed and the foster care crisis is directly related to the 20 years of prescription drugs flooding the state and the failure of the Big Pharma industry to see the damage they caused.

The number of children in state or foster care hit a record low in Massachusetts earlier this decade. Since then, that number has risen by a quarter, and there are now more children in state care than ever before.

In Ohio, the number of children in state custody has grown by 28 percent since 2015. Foster populations are up more than 30 percent in Alabama, Alaska, California, Idaho, Indiana, Minnesota and New Hampshire since 2014. states like Illinois, Oklahoma, Massachusetts, Pennsylvania, Colorado and New Jersey now adopting new approaches to help keep parents and children together, even as parents are receiving treatment for their addictions.

“We are now seeing major opioid related social issues in areas not previously seen, including white suburban communities, urban areas, rural areas, crossing gender lines, racial lines, economic disparity, this flew under the mainstream radar for 15 years”

The opioid epidemic plaguing the nation is taking a catastrophic toll on our most vulnerable group, the children of the opiate addicts and those with substance use disorders. Many children are sent to live with grandparents or other family members, often due to a parent overdose or other addiction displays other problems but tragically, a growing number are being placed in the foster-care system, with many states unable to keep up with the demand from both a budget as well as staffing is struggling to keep up with demand.

From 2013 to 2015, the number of children in foster care nationwide jumped almost 7 percent to nearly 429,000, according to the U.S. Department of Health and Human Services’ Administration on Children and Families, the 2016 to 2018 numbers have moved that number closer to 550,000. Parental substance use was cited as a factor in about 32 percent of all foster placements. From 2000 to 2015, more than half a million people died of an overdose, and currently 91 people a day die from opiate overdoses.

Unfortunately, many children, the indirect victims of the crisis, are not getting the care and services they need. “This is a neglected subpopulation,” says John Kelly, PhD, associate professor of psychiatry in addiction medicine at Harvard Medical School, and the founder and director of the at Massachusetts General Hospital. “Because we’re trying to put out the fire in terms of stopping overdose deaths, we haven’t really been attending to other casualties, including kids most importantly.”

To lessen the long-term effects on children, psychologists are treating children in the foster-care system in outpatient, inpatient and residential treatment programs and in school-based mental health programs.

“Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance.  https://www.ncbi.nlm.nih.gov/pubmed/28406856”

[STUDY OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children]

Everett Washington Schools and Opioids

The front office at an elementary school was never intended as an intake center for drug-counseling and social-services referral hub. For 31 year old Tiffany Smith and others in Everett, it has become just that for the last two years, as she attempts to end her heroin addiction while raising three children.

Smith often chats with the office staff and updates Principal Celia O’Connor-Weaver on her progress in treatment. The first time she ventured inside, Smith carried paperwork from Child Protective Services, and needed to tell the principal that her children, who taken into foster care months before might still get visits from state social workers, even now that the kids were returned home.

Explaining all of this to the principal meant describing what led to the boys’ removal, which meant confessing that she had been addicted to opiates, at times living in her car, the kids staying at her grandmother’s house, until her grandmother finally called state authorities.

“I was afraid of the judgment, that my kids would be affected at school , but it wasn’t that way at all. They said they have a lot of parents that have gone through opiate addictions and what can we do to help? It was not what I was expecting.”

In her six years as principal at the elementary school in Everett, an epicenter of the opioid crisis in Washington, 525 Snohomish County kids were removed from addicted parents just in 2017, in Seattle’s King County, more than 1,000 children were removed.

This problem is now prevalent across the United States where schools, social service agencies and public-health workers scramble to stem adult addictions, less visible have been the reverberations downstream, the children of opioid addicts. Educators and child-welfare workers have reported increased learning problems and behavioral outbursts from the kids of addicted parents. Research suggests dire life-outcomes for these students. Yet the potential for school-based interventions has been underutilized — even as public-health investigators say schools offer the most efficient hope for stemming a looming social crisis.

During the most mundane moments, like recess, teachers watch and 8-year-olds pretend to revive overdosed patients, or hearing how a parent confesses that they’ve relapsed.

The focus of schools should be learning and teaching kids, but often many kids’ minds are not focused on that, they’re worried about their parents, about their next meal and who’s going to be home to take care of them. When a parent becomes addicted or goes into rehab, it changes everything for a family.

Drug users’ children flooding to foster care

In Tiffany Smith’s case, three years of methadone treatment have helped her regain solid enough footing to secure housing and begin working toward a GED, in hopes of becoming a drug and alcohol counselor. But her children are still reeling. Smith’s 6-year-old cannot stand to be apart from his mother and struggles with speech, cognitive and learning delays.

“He was talking fine before foster care,” Smith said. “But when he came out, he couldn’t pronounce some words. They said it was due to the trauma.”

Her older son, now 7, was born prematurely and spent his first two days of life trembling from heroin withdrawal as his mother watched, devastated. “Seeing my baby shake from detoxing really hurt — I knew it was my fault,” she said.

In Washington state, this number is alarming, but not widely known, 10,000 high-school seniors said they’d used heroin or gotten high on opioid-derived painkillers in 2016, those numbers were about the same as two years prior, but foster care placements have surged.

Between 2011 and 2017, the state took children from drug-abusing parents nearly 14,000 times. Last year’s rate was the highest for drug-related causes since 2010 — up 16 percent over 2015 — while state hospitals report a steady increase in substance-exposed newborns.

Child-welfare workers hear complaints about increasingly severe problems in school — more physical violence toward peers, or kids who need to be taught separately — from students whose parents are staggering through addiction, said Jenna Kiser, who oversees intake at the state Children’s Administration.

Jenny Heddin, a state agency supervisor stated, “These numbers are very concerning, when children from these homes come into foster care, they can be very difficult to serve.”

This represent one corner of a national wave. More than 37 states report unprecedented numbers of kids entering foster care, many of them for reasons related to a parent’s substance abuse, according to the federal Department of Education.

Damaging children’s futures

By the time Child Protective Services is knocking on someone’s door, the problem is already severe. And so far, efforts to respond might best be described as triage — focused more on addiction treatment than prevention, both in Washington and across the country.

As in many other states political infighting prevents treatment, earlier this year, Washington Gov. Jay Inslee proposed spending $20 million on a multipronged effort to combat opioid addiction. The bill never made it to the floor for a full vote, and it contained little funding for prevention. (But $1.7 million targeted for youth did get funding.)

Yet researchers warn that ignoring that aspect of the crisis virtually guarantees costly problems to come as the children of addicts grow into adulthood. Kevin Haggerty, a professor at the University of Washington who studies risk factors for drug abuse, authored one of the few peer-reviewed studies tracking life outcomes for these young people.

In the early 1990s, he identified 151 elementary and middle-school children in Washington who were growing up with heroin-addicted parents. Fifteen years later, as young adults, 33 percent had dropped out of high school. The vast majority were addicts themselves, and half had criminal records. Only 2 percent had made it through college. (Nationally, 33 percent of all kindergartners in 1992 grew up to earn a college degree.)

“The results are astounding at how poor the outcomes are, having a drug-addicted parent,” said Caleb Banta-Green, principal research scientist at the Alcohol and Drug Abuse Institute at the University of Washington’s School of Public Health.

“We need to be doing a lot more for kids being parented by opiate-addicted parents — and we’re not.”

“Families literally bring their problems to our door now to help them navigate their lives,” Harrington-Bacote said. “Public schools are doing things that fall way outside of regular academic education. But if they don’t, it’s not going to get addressed at all.”

EXAMPLES OF HOW BIG PHARMA OPIOID Rx MONEY DESTROYS LIVES

Way before social workers showed up in his living room this March, Matt McLaughlin, a 16-year-old with diabetes, had taken to a routine not of his doing, trying to scrounge up enough change for food while his mom, Kelly, went out to use heroin. On a good night, the high school junior would walk his neighborhood in Andover, Ohio to pick up frozen pizza from the dollar store, and on bad nights, he’d play video games to keep his mind off his hunger and unknown blood sugar levels.

When Matt was little, his mom Kelly was a Head Start caseworker who taught parents how to manage their autistic children, who hosted potlucks and played Barbie with Matt’s sister, Brianna. “Growing up, we were the house that everyone wanted to come to,” remembered Brianna, now 20. “I loved every minute of it.”

Kelly had neck surgery and got addicted to OxyContin, and by 2015, she was spending her days napping, disappearing for hours at a time, or going to her neighbor’s house, where she would exchange cash for packets of heroin. She started yelling at the kids, food became scarce, life changed for the worse, “It’s like her personality did a 180,” Brianna said. “I felt like I lost my mom to this pit that I couldn’t pull her out of.”

Ashtabula County Children Services a tip when someone called the police and urged them to check on the family.

She’d been to detox several times over the years, trying to rid herself of what felt like a demon that had taken over her brain. Last year, she managed to stay clean for 63 days, until a friend came over “and laid out a line—and that was all it took.” There are five heroin dealers within a five-mile radius and all more than willing to provide an addict the opiate of choice, which is the norm for rural Ohio anymore.

He kids were once again forced to pack their bags as Kelly would go to detox another time, they were lucky to have relatives nearby: The spiraling opioid epidemic has disrupted so many families that all the foster homes in Ashtabula County are full, this story is repeated across the country every day.

The scourge of addiction to painkillers, heroin, and fentanyl sweeping the country has produced a flood of bewildered children who, having lost their parents to drug use or overdose, are now living with foster families or relatives. In Ashtabula County, in Ohio’s northeast corner, the number of children in court custody quadrupled from 69 in 2014 to 279 last year. “I can’t remember the last time I removed a kid and it didn’t have to do with drugs,” says a child services supervisor. Her clients range from preschoolers who know to call 911 when a parent overdoses to steely teenagers who cook and clean while Mom and Dad spend all day in the bathroom. Often, the kids marvel at how quickly everything changed—how a loving mom could transform, as one teenager put it, into a “zombie.”

The pattern mirrors a national trend: Largely because of the opioid epidemic, there were 30,000 more children in foster care in 2015 than there were in 2012—an 8 percent increase. In 14 states, from New Hampshire to North Dakota, the number of foster kids rose by more than a quarter between 2011 and 2015, according to data amassed by the Annie E. Casey Foundation.In Texas, Florida, Oregon, and elsewhere, kids have been forced to sleep in state buildings because there were no foster homes available, says advocacy group Children’s Rights. Federal child welfare money has been dwindling for years, leaving state and local funding to fill in the gaps. But Ashtabula County is one of the poorest counties in Ohio, and despite a recent boost in funding, the state contributes the lowest share toward children’s services of any state in the country. 

More Broken Families, Less Funding

Ohio also has one of the nation’s highest overdose rates. In 2016, at least 4,149 Ohioans died of drug overdose—a 36 percent jump from the year before, according to the Columbus Dispatch. In 2015, 1 in 9 US heroin deaths occurred in Ohio.

It’s hard to overstate just how pervasive the epidemic feels here. Detective Taylor Cleveland, who investigates drug cases in Ashtabula, told me, “I’m dealing with ruined homes two and three times a day.” Cleveland, who coaches youth soccer and recently adopted a 17-year-old player whose mom overdosed, leads a task force that responds to every overdose in the county. Once, he arrived at an overdose scene only to realize that the victim slouched over in the motel room was his cousin, whose young daughter had called 911. “Every OD that happens, I get a text. I’ve gotten two texts while we’ve been talking.” We’d been talking for less than an hour.

Given the scale of the crisis, it’s not hard to understand why, when Donald Trump promised Ohioans on the campaign trail to “spend the money” to confront the opioid crisis and build a wall so drugs would stop flowing in, locals in this historically blue county took notice. In late October, Trump became the first presidential candidate since John F. Kennedy to visit Ashtabula County. He promised to bring back jobs, to open the long-shuttered steel plants, to build the wall. Twelve days later, Ashtabula residents voted for a Republican president for the first time since Ronald Reagan in 1984.

WHITE HOUSE PROMISED ON OPIOIDS BUT DIDN’T DELIVER

But since he took office, Trump’s plans to tackle the epidemic head-on have fizzled. Republicans’ recent effort to repeal and replace Obamacare would slash funding for Medicaid, which is the country’s largest payer for addiction services—and which covers nearly half of Ohio’s prescriptions for the opioid addiction medication buprenorphine. The bill would enable insurers in some states to get out of the Obamacare requirement to cover substance abuse treatment. A memo leaked in May revealed Trump’s plans to effectively eliminate the White House’s drug policy office, cutting its budget by 95 percent. (The administration has since backpedaled on the plans, following bipartisan criticism.) Trump’s 2018 budget proposes substantial cuts to the Administration for Children and Families, the Substance Abuse and Mental Health Services Administration, and the Temporary Assistance for Needy Families program.

“I think some people felt as though nothing else is working,” said one Ashtabula resident when I asked why so many in a Medicaid-dependent area would vote for Trump. Now, she says, “I’m really, really scared. You don’t get it until you live in a small town and you see people die every day.”

Like so many other Midwest Rust Belt counties, Ashtabula, Ohio has seen better days. Locals proudly tell me that the Port of Ashtabula used to be one of the biggest in the world, where barges unloaded iron mined from Minnesota’s Mesabi Range onto trains headed for the steel mills of the Ohio River Valley. Today, once-bustling streets have given way to vacant storefronts and fast-food chains; the surrounding countryside is made up of farm fields, trailer parks, and junkyards. One in three kids now live below the federal poverty line, less than half of adults have a high school education. The financial downturn accelerated in the ’90s, when manufacturing jobs started disappearing.

Then Opiate Big Pharma and their marketing campaigns introduced newer “less addictive” painkillers like OxyContin and others like Vicodin were liberally prescribed in communities wrestling with dwindling economic opportunity and rife with workplace injuries common to mines, lumberyards, and factories. As authorities started to tighten the rules on prescribing drugs like OxyContin, the use of heroin, which is chemically nearly identical to opioid painkillers, crept up. But the tipping point, for Ohio and the country, came over the past couple of years, when illicit fentanyl, an opioid up to 100 times more powerful than morphine, started making its way into the heroin supply. Since then, says Dr. Thomas Gilson, the medical examiner for nearby Cuyahoga County, the deaths have been coming “like a tidal wave.”

About five years ago, Ohio noticed a major uptick in the number of parents using heroin. More recently, elected officials have learned more about the parasitic way that opioids co-opt the brain and the complex pull of addictions attitudes have softened, with most realizing, there is no good guy or bad guy, once addiction takes hold. The long term problems are often multiplied many times over by lack of short term treatment.

Gov. John Kasich, a notorious budget hawk, made national news when he pushed Medicaid expansion through Ohio’s conservative Legislature. “When you die and get to the meeting with St. Peter,” he told one lawmaker, “he’s probably not going to ask you much about what you did about keeping government small. But he is going to ask you what you did for the poor.” He made news yet again last week, when he signed a 2018 budget that will, for the first time in years, increase the state’s funding for children’s services. Yet the $30 million boost in funding over two years, which will pay foster parents and provide counseling for the kids, won’t make up for the $55 million increase in child placement costs over the past three years. Other than county pilot programs, “No policy or state investment has focused specifically on the children flooding into county agency custody as a result of the opioid epidemic,” concluded a report by the Public Children Services Association of Ohio this spring.

Meanwhile, federal funding for children’s services decreased by 16 percent between 2004 and 2014. That’s due in part to an arcane law stipulating that the largest pot of federal money for children’s services applies only to kids from below a certain income threshold. In many states, that threshold is about half the poverty level—in Ohio, it’s roughly $14,000 per year for a family of four. But the opioid epidemic has afflicted families of all stripes. “A few years ago, I was constantly just in homes that were clearly in poverty,” says Mongenel. Now she’s struck by her new clients’ well-kept houses: “You pull up to it and it’s like, ‘Really?’”

The director of one Ohio county stated “that more caseworkers are quitting than ever before, unable to reconcile the overwhelming caseload with the paltry salary, which starts at $28,500.”

Another addiction case is Amber, a 16-year-old whose mother, Emily, was in and out of rehab for a year, while Emily cycled in and out of rehab. In December, officials got the phone call that Emily had been found dead, slumped over in a motel bed, and a social services worker had to break the news to Amber that they had run out of chances, her mother had died. Today, Amber lives in a what is her new home, a bustling house with nine other foster kids.

Then there is Jake, another 6-year-old with boy-band looks who lived for months in a motel over the 2017 winter with his two younger siblings, taking courses online and playing video games, while his mom went out to use. “He just wanted her to go into rehab and get right,” he told a reporter earlier this year, “If that could be my birthday present or my Christmas present, that’s what it would be.”

Lisa is a 10-year-old, introduced to Ohio social services for the first time in a conference room at her elementary school, the agency rep told her “We’re from children’s services have you ever heard of that before?” Lisa nodded and replied “they’re the people who go to her friend’s house once a month to make sure everything is okay,” in a matter of fact way.

Lisa was asked, “Do you have enough to eat?” and “Do you like where you’re staying?” and Do you know what drug use is?” but it wasn’t mentioned that CPS had just visited Lisa’s house and found her father strung out on heroin in the bedroom they share. Lisa’s bed was a pink sleeping bag on a piece of foam surrounded by pill bottles.

Children in Lisa’s situation are subject to incredible psychological stress. There’s the immediate trauma of living with an unstable parent or being taken from family and sometimes from school and friends. But there’s also the long-term impact. Dozens of studies have found that kids who undergo traumatic events early in life are more likely to suffer mental and physical repercussions later on, be it substance abuse, depression, heart disease, or cancer. Among the 10 so-called Adverse Childhood Experiences, or ACEs, are emotional abuse, physical abuse, separation from parents, and parental substance abuse.

“Every time a child gets into a scary or dangerous situation, it activates their stress response,” explains Dr. Nadine Burke Harris, a pediatrician and founder of the Center for Youth Wellness, which focuses on the developmental effects of childhood trauma. “The repeated activation of their stress response is what leads to the biological condition that we in pediatrics are now calling toxic stress.” Looking at the brains of kids of drug users, Burke Harris says, one would expect to see the signs associated with other types of trauma: an enlarged amygdala, the brain’s fear center; decreased functioning of the nucleus accumbens, the brain’s pleasure and rewards center; and less activity in the prefrontal cortex, which oversees a child’s ability to control impulses and pay attention.

CPS and affiliated social services agencies across the United States are now becoming much more familiar with the latest addiction research on ACEs and impacts on young children. They know that a child with four or more ACEs is twice as likely as other kids to develop cancer and ten times more likely to inject drugs themselves. When they encounter someone like Lisa, they are torn between mitigating one ACE, exposure to parental substance abuse, and catalyzing another: separating a child from her parents. Which is what makes these conversations so heart-wrenching.

For county and state professionals, one of the most difficult things about managing opioid cases is how unpredictable they can be, never knowing how a client’s drug-addicted parent will do after detox. Some thrive and are quickly reunited with their families. Others can’t pull themselves out of the black hole of addiction.

One positive outcome amid the many negatives, is the mother of Matt, the diabetic teenager, Kelly had sailed through detox and been sober for nearly a month, her daughter Brianna had moved back in to help her mom. In the fall Brianna is leaving for college—training to be a social worker, Kelly joked “I’m going to be her first case,” and added “When I was using, I would sleep half the day away” and wake up feeling sick from heroin cravings, she said. “Now I’ve been setting my alarm. I wake up early, enjoy my coffee, open the blinds, and let in the sunshine.” On her walks to town, she said, she crossed the street and looked straight ahead to avoid catching a glimpse of her dealer’s house, an ever-present temptation. Brianna and Matt often visit Kelly at an addiction treatment center.

Every 19 minutes, an opioid addicted baby is born in America., while many of us are well aware of the repercussions of addiction in adults, but very little is understood about the impact it has on infants. After months of being fed opioids through the mother, these babies suffer through excruciating pain.

Imagine, then, how it feels for a baby. Infants who have been exposed to opioid painkillers like morphine, codeine, oxycodone, methadone treatment or street drugs such as heroin while in utero are literally cut off from the drugs when they are born. Within their first 72 hours of life, about half of the babies who have been exposed begin having withdrawal symptoms.

The medical term for this is neonatal abstinence syndrome, or NAS, and rates of babies born with it are rising along with the exponential increase of painkiller use and abuse.

A recent analysis by the Centers for Disease Control estimated that nearly six out of every 1,000 infants born in the U.S. are now diagnosed with NAS. However, experts say that rate is likely higher, as not all states regularly collect such data.

In the USA, Opioid use by women in rural areas is driving the increasing numbers. Tennessee is part of a cluster of states, including Alabama and Kentucky, experiencing some of the highest rates of NAS births. In East Tennessee the problem is particularly acute: Sullivan County alone reported a rate of 50.5 cases of NAS per 1,000 births, the highest rate in the state for five years running.

Tennessee is currently the only state in the country that equates substance abuse while pregnant with aggravated assault, punishable by a 15-year prison sentence. Eighteen other states consider it to be child abuse, and three say its grounds for civil commitment. Four states require drug testing of mothers and 18 require that healthcare professionals report when drug abuse is suspected. There are also 19 states that have created funding for targeted drug treatment programs for pregnant women.

Opponents of the punishment philosophy claim that punishing addicted pregnant women will not stop them from abusing drugs – instead it will stop them from seeking prenatal care. Many also claim that these policies would unfairly punish mothers for drug use compared to fathers. Organizations, such as the American Civil Liberties Union (ACLU) and the American Congress of Obstetricians and Gynecologists (ACOG), have encouraged a treatment over punishment approach for pregnant mothers with drug addictions.

Opioid use by women in rural areas is driving the increasing numbers. Tennessee is part of a cluster of states, including Alabama and Kentucky, experiencing some of the highest rates of NAS births. In East Tennessee the problem is particularly acute: Sullivan County alone reported a rate of 50.5 cases of NAS per 1,000 births, the highest rate in the state for five years running.

In Canada, in the past decade, the number of babies exposed to opioids in the womb has increased 16-fold in Ontario. And according to Ontario’s Provincial Council for Maternal and Child Health (PCMCH), more than 950 infants were born to opioid-addicted mothers last year. Just over half of them will live the toughest days of their lives in their first week outside the womb.

Until the governments at the federal, state and local levels can all agree on a long term viable solution to the opioid crisis and the impact on school age children, infants born addicted and society as a whole, the opiate drug crisis will linger for generations long into the future.

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Richard “Rick” Meadow is the National Mass Tort Leader as well as the Director of Business Development for The Lanier Law Firm. His responsibilities include overseeing all the firm’s pharmaceutical mass tort litigation in addition to promoting, recruiting, and maintaining associated outside relationships at a national level. Rick has represented the rights of individuals who have been injured by pharmaceuticals, medical devices, asbestos, medical malpractice, defective products, construction defects, lead poisoning, and motor vehicles, as well as the negligence of premises owners and municipalities for over 30 years. He further has extensive experience in the representation of large national insurance companies as an insurance defense attorney. This experience provides a 360-degree perspective of the practice of tort law in the United States. 
Rick has developed an extensive practice in mass tort and aggregate litigation. He has been nominated and selected to a variety of leadership positions by both his peers and courts across the country. He has served in leadership positions in many cases that have resulted in nationwide settlements. 
Rick has been working with Mark Lanier for over 30 years and is an integral part of the Lanier Trial Academy Master Class. This year’s Lanier Trial Academy 6.0; https://laniertrialacademy.com/home, will take place on June 20-23, 2022 in Houston Texas. The program includes a third day and more content, including non-verbal cues, voir dire, examinations, and openings and closings. Check out the agenda here, and if you haven’t already, register here: https://myportal.force.com/LanierTrialAcademy/s/lt-event?id=a1U3m00000Ov12TEAR&site=a0d1N000006V1VMQA0#/loginReg!  
 
Read more about Rick here: https://www.lanierlawfirm.com/attorneys/richard-d-meadow/. 
 
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Rick Meadow, Everybody Knows Your Name
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Diandra “Fu” Debrosse Zimmermann is managing partner of DiCello Levitt’s Birmingham office, co-managing partner of the Washington, D.C. office, and co-chair of the firm’s Mass Tort division. Fu is also a member of the firm’s Public Client, Environmental, Personal Injury, Civil Rights, and Trial practice groups.
 
Widely known for her passionate and relentless client advocacy, she represents individuals and public entities that have been injured by wrongful conduct, whether from defective medical devices or drugs, environmental contamination, corporate misconduct, or civil rights abuse. She is nationally recognized as a powerhouse in mass torts, class actions, products liability, discrimination, and sexual assault claims, and has recovered hundreds of millions of dollars in client damages. 
 
On May 27, 2022 Fu made history, becoming the first black woman ever appointed plaintiffs’ Co-Lead Counsel in a multidistrict litigation. She was appointed to the role in the massive products liability MDL, In Re: Abbott Laboratories, et al., Preterm Infant Nutrition Products Liability Litigation, against two of the world’s largest manufacturers of infant formula, Abbott Laboratories (NYSE: ABT) and Mead Johnson. Comprised of more than 60 state and federal lawsuits filed across the U.S., the case stems from allegations against the manufacturers of infant formulas Similac (Abbott) and Enfamil (Mead) by parents of premature infants who were fed with that formula and developed the deadly neonatal condition, necrotizing enterocolitis (NEC). 
 
Fu currently represents individuals exposed to Paraquat, an herbicide thought to cause Parkinson’s disease. She also represents victims of civil rights violations, defective products, and other wrongful conduct. Before joining DiCello Levitt, Fu represented dozens of cities and counties in Alabama, Georgia, and Mississippi against opioid manufacturers and distributors. She has also recovered more than $30 million in damages for victims of catastrophic personal injury, product liability, employment discrimination, and civil sexual assault claims. 
 
Earlier this year, in February 2022, Fu announced that she along with Ben Crump co-founded Shades of Mass, an organization aimed at combatting the lack of diverse attorney leadership in lawsuits that disproportionately impact communities of color. Through collaboration, shared resources, education and networking opportunities, and pressure on our profession, Shades of Mass aims to rectify this inequity and achieve the diversity missing in mass tort and complex litigation case leadership. Learn more about Shades of Mass, its mission, its board members, and its board members here: https://www.law.com/2022/02/28/new-group-to-promote-attorneys-of-color-in-mass-torts/. The organization will be hosting a conference in October 2023 in Atlanta. Visit the Shades of Mass website: http://www.shadesofmass.org/, to learn more. 
 
She is well-known for her relentless and compassionate client advocacy which is only matched by her passion to make this world a better place for the generations to come. Fu has extensive experience handling complex litigation, including pharmaceutical, medical device, environmental contamination, and civil rights matters. And she has earned quite a few accolades for her work, including Top 40 Under 40 attorneys (National Trial Lawyers), Top 10 Under 40 attorney for the State of Alabama (National Academy of Personal Injury Attorneys, Inc.), The National Trial Lawyers: Top 100, one of America’s Top 100 High Stakes Litigators®, and selected as a Top Woman Attorney (B-Metro magazine). 
 
Read more about Fu here: https://dicellolevitt.com/attorney/diandra-fu-debrosse-zimmermann/. 


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Building a Legacy Through Leadership
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John Uustal and the Kelly Uustal Law Firm are a complex personal injury firm based in Fort Lauderdale FL, who are actively involved in traumatic and catastrophic injury litigation and Mass Torts as local trial counsel for certain MDL leadership firms. Also, KU is one of the premier tobacco litigation firms in the country, securing hundreds of millions of dollars in verdicts against Big Tobacco. Never afraid to face corporate bad conduct, John Uustal and the Kelly Uustal firm will take the fight directly to the corporate boardrooms.

Check out John Uustal's blog to stay up-to-date on corporate treachery: https://www.johnuustal.com/
888.522.6601
https://www.kulaw.com

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Calling Out Boardroom Misconduct in the Courts and Court of Public Opinion
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Today we're joined by Majed Nachawati, founder of the Fears Nachawati firm. Majed is well known as a prominent complex commercial litigator in the mass tort space and a leadership firm in emerging torts. Majed's firm is known for representing both individuals and governmental entities in dockets such as the opioid litigation, PFAS water contamination, and other major mass torts. Today we will be discussing three of the most relevant and prominent dockets in the legal world that impact both the plaintiff and defense bar. 

We engage in direct discussions on the Bayer/ Monsanto US Supreme Court appeal in the Hardeman Roundup verdict, originating in California State Court. Recently the US Solicitor General submitted a brief to the Supreme Court advising that the US Department of Justice and other federal agencies are not in favor of participating in the Monsanto- Hardeman appeal.

We then go into the Johnson & Johnson Talcum Powder MDL and related state court litigation where J&J is using the Texas Two-Step legal process to file bankruptcy, related to their talcum powder liabilities, which are expected to exceed $12 billion. Majed is also a member of the J&J bankruptcy creditor's committee.   

Majed also discusses his lead role in the Texas winter freeze litigation, where the Texas Utility Power Commission and the power grid tragically failed the citizens of Texas and numerous lives were lost, properties were destroyed and damaged. Fears Nachawati was in a leadership role from the outset of the Texas winter freeze litigation, when they filed the first lawsuit within one week of the freeze taking place. The claims in this docket relate to the catastrophic failure of the utility and regulatory entity within the state of Texas to properly ensure the safety of its citizens. Majed clearly states that it is his position in the Texas winter freeze, Monsanto roundup, and the Johnson and Johnson talcum powder litigation to be an assertive representative of firm clients in these dockets to hold the corporate parties accountable for the ongoing and embedded bad conduct, which is clearly evident in the media and now being shown in a court of law.

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Fighting Bad Conduct in America's Boardrooms
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John K. Rabiej served as the Deputy Director of the Bolch Judicial Institute for one year, and as the Director of the Duke Law Center for Judicial Studies for seven years. The Duke Law Center brings together judges, lawyers, researchers, government officials and other parties to advance the study and understanding of the judicial process and generate ideas for how it might be improved. During his time as the Director of the Duke Law Center, Mr. Rabiej studied the impact of technology on the judiciary, including analyzing his concerns that the courts are not keeping pace with the rapid advancement of technology in the culture at large. Prior to joining the Duke Law Center, Mr. Rabiej served as the Executive Director and Director of Judicial Outreach for The Sedona Conference; the Chief of the Rules Committee Support Office; and the American Law Institute. He presently sits on the Chief Justice’s Rules Advisory Commission, North Carolina (term ending December 31, 2023). In this episode of LegalCast, Mr. Rabiej discusses a legal bipartisan review of mass torts, class action, and the ever-expanding e-discovery quagmire that seems to be firmly embedded in complex litigation coming to a peak in 2022.  Will the plaintiffs and defense leadership be able to collaborate to reign in the ever-expanding high cost of litigation? Mr. Rabiej has made a career of working to bring opposing groups together to discuss common interests as a means to increase efficiencies in litigations. And, with millions of dollars at stake, why not at least start the discussions.

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Is Judicial Review On The Horizon?
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Stephen P New. of Beckley West Virginia is one of the country’s leading opioid litigators, by bringing the fight directly to Opioid Big Pharma's doorstep. Steve and the Opioid Justice Team have been defending and advocating for the rights of the neonatal abstinence syndrome afflicted infants, aka the "NAS Babies." Who are the truly innocent victims of the now decades-old opiate crisis in America.

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Leading the Fight for Opioid Addicted Infants
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George Haj is a Pulitzer-Prize winning editor who founded Haj Media in 2017. Haj Media is a strategic communications firm focusing on crisis communications, media relations, and litigation support for law firms and corporate clients. Prior to launching his own consulting firm, George spent three decades working in some of the nation’s largest news organizations. He has deep roots in the media industry and connections with reporters and editors in a range of publications across the country. George worked as executive business editor at the Miami Herald and then was a top editor at the Houston Chronicle. He also served as editorial director of ALM Media, where he directed a global newsroom of more than 100 journalists and oversaw iconic brands including The American Lawyer and National Law Journal. He can be reached at george@hajmedia.com. Find him on Twitter: https://twitter.com/georgehaj, LinkedIn: https://www.linkedin.com/in/george-haj-25ba481, and at http://www.hajmedia.com/. 

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Crisis Management & Media Training for Lawyers
YouTube Video VVVuSC1KSll3UzVNWHQwMEgyUndoR3Z3LmhvVDk2Q2MxUnpR
With four decades of experience in legal advertising with a passion for legal marketing, intake, and conversion, Harlan Schillinger has more than earned his title as the Grandfather of Legal Advertising. 

Harlan was the first in the industry to produce and market TV advertising for the legal community. In 1975, along with his partners, Harlan founded the first syndication TV production firm for high-end retailers and Lawyers, creating television commercials that aired throughout North America.

Since the late 1970s, Harlan has worked aggressively, productively, and professionally within the legal advertising space. He has said that: “Creating opportunities and increasing market share for advertising law firms is [his] #1 priority. The value of the case is everything in such a crowded market.” Harlan privately consults with lawyers who not only share his values, but who also share his vision of increasing business, being accountable, and obtaining high-value cases. His approach to intake and conversion rests on complete accountability within that area and he is known to practice what he preaches. Harlan has trademarked within the legal advertising world the two phrases that have become his backbone of philosophy: What You Don't Know, You Don't Know® and Ambassador of First Impressions™.

Since that time, Harlan has worked with more than 130 law firms in almost 100 markets throughout North America. Before joining Network Affiliates in 1985, Harlan was a founding partner and VP of Madison, Muyskens & Jones, a Connecticut-based advertising agency. In April 2016 Harlan retired from Colorado-based Network Affiliates, the nation's first and largest full-service legal advertising agency, where he was the leader of their attorney marketing efforts for over 34 years.

A few years ago, Harlan and two of his partners – Dino Colombo Esq. and Eric Coffman – developed Lead Docket, software for intake and conversion within law firms. Harlan says that Lead Docket helps law firms increase control and management of intake and conversion, allowing the firms to thrive.

Harlan is involved with a number of professional organizations, being a member of the National Trial Lawyers Executive Summit Committee as well as a Senior Editor and Writer for the National Trial Lawyers Magazine. He also has a passion for riding and building custom motorcycles, and is a proud member of the most prestigious motorcycle group in the world: Hamsters USA ® Motorcycle Group.

Learn more about Harlan at http://www.harlanschillinger.com/. 
And to check out the book he recommends – How to Win Friends & Influence People by Dale Carnegie and originally published in 1936 click here: https://www.amazon.com/How-Win-Friends-Influence-People/dp/0671027034. 

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Prep Like a Pro: Legal Networking Tips & Tricks
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