Last week, Drug Safety News brought you a story about the growing opioid epidemic in the U.S. and how rural regions of the country have been the most affected. This was according to a report by the U.S. Surgeon General’s Office that was released earlier this year.
Now, an investigative report by the Charleston (West Virginia) Gazette-Mail pinpoints and highlights that addiction crisis. It turns out that some major drug companies have been flooding rural West Virginia with prescription painkillers that include oxycodone and hydrocodone – where the addiction and death rate from overdoses are among the highest in the U.S.
Over a five-year period between 2007 and 2012, a total of 780,069,272 dosages of these two drugs were shipped to West Virginia pharmacies. That works out to an average of 433 pills for every West Virginian. In the hardest-hit counties – which not coincidentally, are the most impoverished – dosages per person are as high as 215.
The Gazette-Mail was able to get these figures from the DEA. Not surprisingly, wholesalers and distributors have been fighting an ongoing legal battle to keep this information from coming out.
It’s out there, now.
Even as the death rate from opioids continued to rise, big drug distributors like McKesson, Cardinal Health and AmerisourceBergen (the three largest) continued to rake in billions of dollars in profits, paying their CEOs handsome bonuses. To put that in perspective, McKesson CEO John H. Hammergren got a total compensation package last year of $89 million – which is more than the combined yearly income of 2,000 West Virginia families, many who have suffered because of their business.
How did this happen? Aren’t there supposed to be laws and regulations in place to prevent this sort of thing?
In fact, there are. The Virginia Code of State Rules requires wholesale distributors to have mechanisms in place to detect “suspicious” orders and report these to the state pharmacy board. A similar rule is contained in Title 21 of the Code of Federal Regulations. Among other things, prescription drug distributors are required to note orders “of unusual size, orders deviating substantially from a normal pattern, and orders of unusual frequency.” However, those drug companies have largely been ignoring their legal obligation – and it’s easy to see why. Over that five-year period, the “Big Three” distributors raked in approximately $17 billion.
It gets even worse. As the demand for opioids increased, so did the strength of the dosages. It was a conscious effort to keep addicts hooked – making companies like McKesson no better than street dealers.
Of course, they were able to get away with it because of lax enforcement. It has been too easy to get prescriptions from doctors and pain clinics, and pharmacies haven’t been too particular about who they sell the pills to. Retired pharmacist Sam Suppa told the Gazette-Mail, “They’re all in bed together…they just didn’t care.”