December 23, 2016
The United States is embroiled in a fierce battle against opioid abuse. In 2014, there was a 3.4-fold increase in the number of opioid overdose deaths in America. The state hit hardest by the opioid crisis is West Virginia, where drug companies pumped 782 million pain pills into the state over the last 6 years.
In 2015, West Virginia had the highest rate of opioid overdose deaths in the country. Since 1999, overdose deaths have quadrupled in the state.
The Charleston Gazette-Mail obtained previously confidential drug shipping sales records sent by the DEA to West Virginia Attorney General Patrick Morrisey’s office. The paper used the records to disclose the number of pain pills sold to every pharmacy in the state, as well as the drug companies’ shipments to all 55 counties in West Virginia between 2007 and 2012.
Their findings, both astounding and infuriating, were documented in a report published in the paper on December 17.
One drug company shipped nearly 9 million hydrocodone pills to a single pharmacy in Mingo County over the course of 2 years. The rural, impoverished county has the 4th-highest prescription opioid death rate of any county in the U.S.
In Wyoming County, which has the highest overdose rate in the entire nation, shipments of OxyContin doubled. One privately-owned pharmacy in the town of Oceana received 600 times as many oxycodone pills as the Rite Aid pharmacy only 8 blocks away.
In total, from 2007 to 2012, drug companies shipped 224,260,980 oxycodone pills to West Virginia. Wholesalers flooded the state with 555,808,292 hydrocodone pills during the same time period.
No wonder drug wholesalers and their lawyers fought against the Gazette-Mail getting its hands on those shipping records. They went so far as to bring court actions against the newspaper to stop it from publishing the numbers.
Former Delegate Don Perdue, a Democrat from Wayne County, said:
“These numbers will shake even the most cynical observer.”
Perdue, a retired pharmacist, added:
“Distributors have fed their greed on human frailties and to criminal effect. There is no excuse and should be no forgiveness.”
The Biggest Offenders
Even as overdose deaths continued to climb throughout West Virginia, drug companies continued shipping mountains of pills into the state. The majority of the painkillers came from the nation’s 3 largest prescription drug wholesalers: McKesson Corp., Cardinal Health, and AmeriSource Bergen Drug Co. These companies supplied more than half of all opioid pills sold statewide during those 6 years.
McKesson, Cardinal, and AmeriSource spent a decade sidestepping rules requiring them to report suspicious orders for controlled substances in West Virginia to the state Board of Pharmacy, the newspaper found. Not that it would have mattered anyway; the board failed to enforce the same regulations that were established in 2001. Rather, the board gave glowing inspection reviews to mom-and-pop pharmacies in the southern counties that ordered more opioids than could possibly be taken by people with legitimate prescriptions for pain.
From 2007-2012, opioid overdose deaths in West Virginia skyrocketed 67%. While people were dying, the drug wholesalers’ CEOs raked in salaries and bonuses in the tens of millions of dollars. McKesson, the 5th-largest corporation in America, had the highest-paid executive in the country in 2012.
McKesson has had its fair share of run-ins with the law over its pain pill distribution.
The company was sued by the DEA and 6 other states in 2008 for supplying hundreds of suspicious hydrocodone orders to rogue pharmacies. McKesson settled the lawsuit by agreeing to pay more than $13 million in fines and monitor its pill supply more closely.
In January 2016, Attorney General Morrisey sued McKesson, alleging that the distributor violated West Virginia consumer protection laws and the Uniform Controlled Substances Act by flooding the state with tens of millions of pain pills.
In the lawsuit, Morrisey also alleged that between 2007 and 2012, McKesson delivered nearly 100 million doses of hydrocodone and oxycodone to the state. Of that total, 3.4 million doses went to Mingo County alone.
Drug wholesalers have defended themselves in court cases by pointing out that there wouldn’t be such a heavy demand for pain pills if there weren’t so many doctors prescribing them. Furthermore, the drugs would never reach patients’ hands without the willing participation of pharmacists.
McKesson General Counsel John Saia wrote in a company letter:
“The 2 roles that interface directly with the patient – the doctors who write the prescriptions and the pharmacists who fill them – are in a better position to identify and prevent the abuse and diversion of potentially addictive controlled substance.”
They do have a point, but it makes them no less guilty.
Year after year, McKesson and the other distributors shipped more and more pills into the state. McKesson supplied Mingo County with more hydrocodone pills in a single year – 3.3 million – than it supplied over 5 other consecutive years combined.
The potency of the pills being shipped kept increasing, too, according to DEA data.
Sam Suppa, a retired Charleston pharmacist who spent 60 years working at retail pharmacies in West Virginia, said:
“It starts with the doctor writing, the pharmacist filling, and the wholesaler distributing. They’re all 3 in bed together. The distributors knew what was going on. They just didn’t care.”
Between 2007 and 2012, McKesson, Cardinal Health, and AmeriSource collectively shipped 423 million pain pills to West Virginia, earning themselves a combined net income of $17 billion.
Over the past 4 years, the 3 companies’ CEOs collectively received salaries and other compensation of more than $450 million. Last year, McKesson’s CEO collected compensation worth $89 million. That’s more than the incomes of 2,000 West Virginia families combined.
Any financial punishment against a distributor is laughable and ineffective.
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