America is still wrestling with blame for its opioid epidemic

This illustration image shows tablets of opioid painkiller Oxycodon delivered on medical prescription taken on September 18, 2019 in Washington,DC.

This was excerpted from the May 5 edition of CNN's Meanwhile in America, the daily email about US politics for global readers. Click here to read past editions and subscribe.

(CNN)It was an American epidemic long before Covid-19.

Opioid addiction and overdoses have scythed through the US heartland, often compounding misery in regions already ravaged by economic desperation. Between 1999 and 2019, more than 247,000 people died in the US from overdoses involving prescription opioids, according to the Centers for Disease Control and Prevention. In 2019 alone, nearly 50,000 Americans were killed by overdosing on powerful synthetic drugs like fentanyl.
Who is to blame for this addictive cycle? The drug firms — some of which have been lauded for their role in the lightning-fast development of the Covid-19 vaccine — that pumped opioids into vulnerable communities? The pharmacies that distributed them? Or did doctors create the path for the epidemic by overprescribing new drugs for chronic pain?
    These questions may start to be sorted out in West Virginia, where a trial has just opened with Big Pharma firms McKesson Corp., AmerisourceBergen and Cardinal Health on the stand. It will help test whether an opioid case can be successful at trial against pharmaceutical companies under a claim of "public nuisance" for failing to monitor, divert or report suspicious or excessive orders under the Controlled Substances Act.
      The case is being brought by Cabell County, West Virginia, and the city of Huntington. The three firms funneled more than 57 million doses of hydrocodone and oxycodone to a community of just 100,000 people over eight years starting in 2006. Lawyers for the defendants argue that their clients did not break the law and were not responsible for prescribing the drugs to patients.
        The trial, one of the first of what could be hundreds of cases to reach the court, could provide important precedents as to the culpability of Big Pharma firms and the price it may have to pay to end the blizzard of lawsuits.

        Inside the bear pit

          Republican California gubernatorial candidate John Cox greets a 1,000 pound bear at the start of a campaign rally at Miller Regional Park on May 04, 2021 in Sacramento, California.
          American politics is often likened to a bear pit. But most candidates for office don't take the ursine metaphor quite so literally as California's John Cox. The businessman launched his bid to unseat California Gov. Gavin Newsom on Tuesday with a real live Kodiak bear in tow — apparently in homage to the official state animal.
          Newsom's term is not scheduled to end until 2023. But he's facing an unusual recall election, triggered when nearly 1.5 million people signed a petition calling for his ouster. A similar mechanism brought the Terminator, Arnold Schwarzenegger, to power as Republican governor in 2003.
          Unlike Arnie, Newsom can't say for sure that he'll be back, since he is taking heat for his handling of the Covid-19 pandemic. Conservatives argue he was too slow in reopening the economy, though the virus was still rampant. Some liberals say he was not strict enough. Newsom, a Democrat, also managed to fall foul of the political spin cycle after being caught at a party in a restaurant -- the kind of event he had been telling other Californians to avoid.
          This being California, the race promises to be a colorful one.
          Another GOP candidate is Caitlyn Jenner, a transgender woman and activist who as Bruce Jenner won the gold medal in the men's decathlon at the Montreal Olympics in 1976. Jenner's fame may help explain why Cox, who was drubbed by Newsom in the Golden State's 2018 gubernatorial election, felt compelled to add a little pizzazz to his own campaign.
            The lumbering, docile star of Cox's show didn't appear overly impressed by the Republican's pitch. But the bear takes top billing alongside the candidate in a new campaign ad that mocks Newsom's good looks and says voters chose "pretty over accomplished" when they elected him over Cox three years back. "Do you want beauty or a ball-busting beast?" the narrator asks, over footage of a roaring bear, apparently supposed to show that the straitlaced and very un-bear-like Cox is up for a bit of self-mockery.
            It's too early to say whether the gimmick will help Cox claw his way into the race. But if he loses, headline writers could do worse than reach for one of Shakespeare's most famous stage directions to encapsulate his humiliation: "Exit, pursued by a bear."