Pubdate: Mon, 19 Dec 2016
Source: Chicago Tribune (IL)
Copyright: 2017 Chicago Tribune Company
Contact:  http://www.chicagotribune.com/
Details: http://www.mapinc.org/media/82
Author: Tribune news services

DEA RECORDS SHOW W. VA. FLOODED WITH 780 MILLION PAINKILLERS IN SIX YEARS

[photo] Hydrocodone at a pharmacy in Montpelier, Vt. (Toby Talbot / AP)

Drug wholesalers shipped 780 million hydrocodone and oxycodone pills to
West Virginia in just six years, a period when 1,728 people fatally
overdosed on these two painkillers, according to an investigation by the
Charleston Gazette-Mail.

That amounts to 433 of the frequently abused opioid pills for every man,
woman and child in the state of 1.84 million people.

The Gazette-Mail obtained previously confidential records sent by the U.S.
Drug Enforcement Administration to the office of West Virginia Attorney
General Patrick Morrisey. They disclose the number of pills sold to every
pharmacy and drug shipments to all 55 counties in West Virginia between
2007 and 2012.

Four of these counties -- Wyoming, McDowell, Boone and Mingo -- lead the
nation in fatal overdoses caused by pain pills, according to the U.S.
Centers for Disease Control and Prevention.

The records -- which leading drug wholesalers had fought in court to keep
secret -- show the wholesalers shipped ever-higher doses of the pills -- a
telltale sign of growing addictions -- even as the death toll climbed, the
newspaper reported on Sunday.

"These numbers will shake even the most cynical observer," former Delegate
Don Perdue, D-Wayne, a retired pharmacist who finished his term earlier
this month, told the newspaper. "Distributors have fed their greed on
human frailties and to criminal effect. There is no excuse and should be
no forgiveness."

There's something particularly agonizing about these deaths, even for a
funeral director.

"It's the senselessness of it," John Romeyn said.

It's the father who sobbed as he sat across from him at a table in his
funeral home near Vancouver, British Columbia. It's the look on the
father's face as...

There's something particularly agonizing about these deaths, even for a
funeral director.

"It's the senselessness of it," John Romeyn said.

It's the father who sobbed as he sat across from him at a table in his
funeral home near Vancouver, British Columbia. It's the look on the
father's face as... (Samantha Schmidt)

McKesson Corp., Cardinal Health and AmerisourceBergen Drug Co. together
control about 85 percent of the U.S. drug distribution market by revenue
and provided more pills to West Virginia than other wholesalers.

As hydrocodone and oxycodone overdose deaths increased 67 percent in West
Virginia between 2007 and 2012, their chief executives were paid millions
and their companies made billions. McKesson became America's fifth-largest
corporation, with the nation's highest-paid CEO in 2012, according to
Forbes.

The drug distributors say they're just middlemen in a highly regulated
industry and that pills would never get in the hands of addicts and
dealers if not for unscrupulous doctors who write illegal prescriptions,
and pharmacists who turn a blind eye.

"The two 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," McKesson General Counsel John
Saia wrote in a letter released by the company, the newspaper reported.

But the doctors and pharmacists weren't slowing the influx, and the pills
being shipped became much more potent, DEA records show.

"It starts with the doctor writing, the pharmacist filling and the
wholesaler distributing. They're all three in bed together," said Sam
Suppa, a retired Charleston pharmacist who spent 60 years working at
retail pharmacies in West Virginia. "The distributors knew what was going
on. They just didn't care."

The largest shipments often went to independent drugstores in small towns.
The Tug Valley Pharmacy in Mingo County, which had fewer than 24,000
people in 2010, ordered more than 3 million hydrocodone pills in 2009,
while franchisees of Rite Aid and Wal-Mart ordered only several thousand
each year, the newspaper reported.

Morrisey is a Republican who represented Cardinal Health and lobbied for
wholesalers in Washington, D.C., before winning the attorney general's
race with strong backing from drug companies. He recused himself from the
state's lawsuit against more than a dozen wholesalers after taking office
in 2013. In January, Morrisey's office sued McKesson separately. Nine
smaller wholesalers have settled for more than $7.5 million. Cases against
the big three remain pending.

DEA agent Kyle Wright warned Morrisey aides in January 2015 that the
wholesalers were shipping both opioids in more potent, commonly abused
dosages, according to emails Morrisey released in response to a Freedom of
Information Act request from the Gazette-Mail.

McKesson denied paying these incentives. A spokesman for AmerisourceBergen
suggested health experts and law enforcement would be better able to
comment on whether there's a link between pain-pill volumes and overdose
deaths.

"All parties including pharmacies, doctors, hospitals, manufacturers,
patients and state officials share the responsibility to fight opioid
abuse," said Ellen Barry, a spokeswoman for Cardinal Health.

Cardinal told The Associated Press on Monday that it now has "rigorous
control processes in place to address the constantly changing tactics" of
people trying to divert drugs.

The newspaper interviewed the family of Mary Kathryn Mullins, who was
prescribed OxyContin for pain in her back after a car crash near her home
in Boone County.

"They wrote her the pain pills, and she just got hooked," said her mother,
Kay Mullins. "She'd get 90 or 120 pills and finish them off in a week."

As her addiction worsened, she went to dozens of doctors, visiting pain
clinics that churned out illegal prescriptions by the hundreds and
pharmacies that dispensed doses by the millions. She kept most for
herself, but sold some to others, Kay Mullins said.

Last December, she got a new prescription for OxyContin and an
anti-anxiety medication. Two days later, she stopped breathing. Her
brother Nick Mullins, a Madison police officer, responded to the 911 call.
He tried chest compressions, but he could not revive his sister.
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