Walmart is doubling down on its efforts to curb opioid abuse. Time Even as overdoses and deaths from prescription painkillers devastated the nation, two of the largest drug distributors in the United States delivered at least 12.3 million opioid painkillers to a single pharmacy in tiny Mount Gay-Shamrock, W.Va. — population 1,779 — over eight years starting in 2006.
That’s more than 6,900 pills for every man, woman and child in the small town. Even that accounts for only a fraction of the prescription opioids that distributors pumped into rural towns in West Virginia — a state with the nation’s highest rate of overdose deaths in 2016.
Did any of these sophisticated corporations think there was something odd about millions of pills going to independent pharmacies in rural areas? On Tuesday, top executives of five opioid distributors had their chance to answer before a House committee that has been investigating pill dumping in West Virginia.
OPPOSING VIEW: Don’t blame pharmaceutical distributors
The moment produced a couple of apologies, a bunch of lame excuses and an astonishing assertion by four of the executives that their companies made no contribution to the opioid epidemic that has killed 300,000 people in the USA since 1999.
“No” was the answer from three of the nation’s biggest drug distributors — McKesson, Cardinal Health and AmerisourceBergen — and one regional distributor, H.D. Smith Wholesale Drug Co. Only one, Miami-Luken, owned up to responsibility.
Rep. David McKinley, R-W.Va., was right to call the denials “particularly offensive.”
Along with overprescribing doctors, lax federal authorities and greedy manufacturers that misled doctors and the public about the addictive nature of opioids, negligent distributors played a role in turning painkillers into instruments of misery and death.
Distributors are the middlemen in the opioid pipeline, moving pills from manufacturers to pharmacies that serve the public. They are in a strategic position to take note when a pharmacy is buying up a suspicious volume of painkillers.
Under federal law, distributors must operate a system to disclose “suspicious orders of controlled substances,” which include orders of “unusual size” or “unusual frequency,” and inform the Drug Enforcement Administration (DEA) about them.
The companies testifying Tuesday before the House Energy and Commerce panel insisted they had such systems in place and have improved systems at work today, though clearly something was amiss, and not just in West Virginia.
In 2008, Cardinal and McKesson each paid multimillion dollar civil penalties to settle federal allegations that each had failed to report to the DEA “suspicious sales” to pharmacies. Apparently, $47 million in penalties wasn’t enough to keep their attention.
Both companies made similar settlements in recent years, with McKesson agreeing to pay a record $150 million last year at the same time it suspended sales of controlled substances in Colorado, Ohio, Michigan and Florida.
This is an epidemic that knows no boundaries, kills indiscriminately, and will not be vanquished by any single action. The trick now is to reduce the supply of prescription painkillers in a way that doesn’t deprive people of needed pain relief or drive more addicts to lethal street drugs. Even as opioid prescriptions have declined in recent years, deaths from heroin and illicit synthetic opioids have surged.
Addressing the crisis will take more dexterity than anybody involved in this fiasco has demonstrated. And it will require buy-in from all the players — doctors, pharmacists, manufacturers, government regulators, law enforcement and, yes, the distributors that flooded the nation with addictive pills.