Brian Mann

In a surprise ruling late Wednesday a federal judge in New York allowed work to continue on implementation of a controversial bankruptcy plan for Purdue Pharma, the maker of Oxycontin.

Internal documents cited during the opening session of a landmark opioid trial in Cleveland suggest the nation's biggest pharmacy chains were warned by employees about the dispensing of highly addictive pain pills.

Mark Lanier, lead attorney for two Ohio counties suing CVS, Giant Eagle, Walgreens and Walmart, read the documents into the court record as part of his opening statement.

"Walgreens is not verifying the legitimacy of suspicious orders, which could lead to the fulfilment of an illicit order," said one Walgreens memo cited by Lanier.

On Monday in a federal courtroom in Cleveland, Ohio, the nation's legal reckoning over the opioid crisis shifts to four name-brand pharmacy chains: CVS, Giant Eagle, Walgreens, and Walmart.

The companies say they did nothing wrong in the way they dispensed highly addictive pain pills. But the jury trial now getting underway could expose them to billion of dollars in liability and huge risk to their reputations.

Critics say they were reckless in the way they dispensed opioid pain pills, ignoring red flags as more and more people became addicted.

The Cherokee Nation in Oklahoma has reached a $75 million opioid settlement with three of the nation's largest drug distributors, the first deal of its kind with a tribal government in the country.

AmerisourceBergen, Cardinal Health and McKesson shipped vast quantities of highly addictive pain pills over the past 20 years, triggering an avalanche of lawsuits.

In a statement, Cherokee Nation Principal Chief Chuck Hoskin Jr. said the opioid crisis had disproportionately affected people in his community.

In its first public safety alert in six years, the Drug Enforcement Administration is warning about a dramatic increase in fake prescription drugs being sold on the black market containing a potentially lethal dose of fentanyl.

I set out on the kind of leaf-peeping trip you take when you want solitude with your fall color. That means driving miles of dirt roads through New York's Adirondack Mountains to reach Quebec Brook, a winding boreal river in the middle of nowhere.

My canoe is a small, ultralight boat designed for this kind of wilderness paddling. That's good because the river is hard to navigate, winding through alder thickets, taking me into a maze of winding marsh.

When Winnie White Tail convened a new session of inpatient substance use treatment last month for members of the Arapaho and Cheyenne tribes, she found that roughly half her clients were struggling with methamphetamine addiction.

"It's readily available, it's easy to get," White Tail says. She's a Cheyenne tribal member herself and runs the George Hawkins Memorial Treatment Center in Clinton, Okla.

A division of the Justice Department that serves as a watchdog over the federal bankruptcy system filed an appeal late Wednesday seeking to block the controversial Purdue Pharma bankruptcy plan.

William Harrington, who serves as U.S. trustee for the Justice Department, also filed documents requesting an "expedited stay" to prevent implementation of the settlement.

Members of the Sackler family who are at the center of the nation's deadly opioid crisis have won sweeping immunity from opioid lawsuits linked to their privately owned company Purdue Pharma and its OxyContin medication.

Federal Judge Robert Drain approved a bankruptcy settlement on Wednesday that grants the Sacklers "global peace" from any liability for the opioid epidemic.

Purdue Pharma launched a behind-the-scenes effort in recent days aimed at discouraging the Justice Department from appealing a pending multibillion-dollar bankruptcy settlement for the OxyContin-maker.

NPR acquired an early draft of a letter distributed by the drug company to groups supportive of the bankruptcy deal.

A federal bankruptcy judge says he'll rule Friday on the fate of Purdue Pharma and its owners, members of the Sackler family, who are at the center of a national reckoning over the deadly opioid epidemic.

Judge Robert Drain signaled he is likely to approve the reorganization plan for the makers of OxyContin.

But he also demanded last-minute changes limiting legal immunities granted under the deal to the Sacklers and their associates.

Buried at the bottom of reams of legal documents filed as part of the Purdue Pharma bankruptcy case is a single-spaced list that goes on for more than a dozen pages.

It details hundreds of individuals, companies, trusts and other organizations, including financial advisers, public relations firms, law firms, lobbyists, drugmakers and laboratories.

Bankruptcy proceedings against Purdue Pharma, the maker of Oxycontin, have often been opaque and bureaucratic, the outcome of the multi-billion dollar settlement shaped by backroom deal-making.

But woven into the court record are dozens of personal letters written by people who say their families were ravaged by addiction that began with the company's powerful pain pills.

The outcome of a landmark federal opioid trial in West Virginia that reached closing arguments this week rests on two legally thorny questions.

Was it "unreasonable" for three of America's biggest corporations — the drug wholesalers AmerisourceBergen, Cardinal Health and McKesson — to ship roughly 81 million highly addictive opioid pills to pharmacies in one small Rust Belt city on the Ohio River?