prescription drug abuse Story Archives - West Virginia Public Broadcasting

Feds: McKesson Agrees to Pay $150M in Pill Shipment Case

A major California-based drug wholesaler has agreed to pay $150 million to settle allegations that it failed to detect and report pharmacies’ suspicious orders of prescription pain pills, federal prosecutors said Tuesday.

The settlement commits San Francisco-based McKesson Corp. to a multi-year suspension of sales of controlled substances from distribution centers in Colorado, Ohio, Michigan and Florida. It also imposes new and enhanced compliance requirements on McKesson’s distribution system.

The suspensions are among the most severe sanctions ever agreed to by a Drug Enforcement Agency-registered distributor, according to a statement by the U.S. Justice Department and the U.S. attorney’s office for West Virginia’s northern district.

“Today’s settlement sends a clear message to all distributors of pharmaceutical drugs that it is essential to dispense controlled substances in compliance with DEA’s record keeping requirements,” DEA Special Agent in Charge Karl C. Colder said in the statement.

In 2008, McKesson agreed to a $13.25 million civil penalty for similar violations.

Chairman and CEO John H. Hammergren said in a statement that McKesson is “committed to tackling this multi-faceted problem in collaboration with all parties in the (prescription drug) supply chain.”

According to the settlement, a former McKesson distribution facility in Landover, Maryland, allegedly routinely failed to report suspicious orders of placed by routine pharmacies from 2008 to 2012 in violation of the Controlled Substances Act.

“In many instances, the suspicious orders placed by West Virginia pharmacies resulted in prescription narcotics being diverted for illegal use and abuse,” said Betsy Steinfeld Jividen, the acting U.S. attorney in northern West Virginia.

One of those pharmacies was Judy’s Drug Store in West Virginia’s Grant County. The pharmacy settled a federal investigation for $2 million and that led to the investigation of McKesson, Jividen said.

Prosecutors said McKesson did not fully apply or adhere to a compliance program that it designed after the 2008 settlement to detect and report suspicious orders to independent and small-chain pharmacy customers.

For example, McKesson process more than 1.6 million orders for controlled substances in Colorado from 2008 to 2013 but reported just 16 orders as suspicious, the settlement noted. It said all of those suspicious orders were tied to one instance of a customer who was recently terminated.

McKesson is the latest distributor to agree to settlements in West Virginia over painkiller shipments. Earlier this month, Cardinal Health agreed to pay $20 million and AmerisourceBergen will pay $16 million to settle a lawsuit filed by West Virginia alleging they fueled West Virginia’s opioid epidemic with excessively large shipments of painkillers over several years.

Earlier, the state settled similar claims against other wholesalers for another $11 million.

A Charleston Gazette-Mail investigation found drug wholesalers shipped 780 million hydrocodone and oxycodone pills to West Virginia in six years, a period when 1,728 people statewide fatally overdosed.

Drug Companies Profit from Opioid Epidemic While Regulators Look the Other Way

Drug wholesalers sent 780 million hydrocodone and oxycodone pills into West Virginia over six years, according to an investigation by the Charleston Gazette-Mail.

Meanwhile, 1,728 West Virginians died from overdoses of these two powerful painkillers.

Who let it happen? Investigative reporter Eric Eyre, of the Charleston Gazette-Mail, answered our questions about his series on The Front Porch.

(Caution: This week’s podcast contains a vulgar slang word.)

1. What was the biggest surprise for you?

Drug wholesalers shipped enough painkillers to provide 433 pills for every man, woman and child in the state, Eyre said. And in parts of the southern West Virginia coalfields, the numbers were even higher.

“I was surprised that some of the smallest pharmacies had some of the biggest numbers,” Eyre said. For example, nearly 9 million hydrocodone pills to one pharmacy in Kermit, W.Va., population 392.

“In Oceana, one pharmacy received 600,000 – 700,000 oxycodone pills a year. The Rite Aid six blocks away gets 6,000.”

2. Did the drug wholesalers do anything illegal?

“They have a legal obligation to report these suspicious orders to the (federal) Drug Enforcement Agency,” and to the state Board of Pharmacy, Eyre said.

For years, none of them did. But after a lawsuit was filed by former state Attorney General Darrell McGraw, some wholesalers began to send suspicious order reports to the Board of Pharmacy.

3. What did the Board of Pharmacy do with those reports of suspicious orders from the drug wholesalers?

They put them in a box, Eyre said. They did not tell law enforcement or even tally the information on a computer.

Eyre asked the board’s director about this: “He said the law does not prescribe what they’re supposed to do with the suspicious report, only that they’re supposed to be filed.”

Now, the board is considering sharing these with the State Police or Attorney General.

4. How do the drug wholesalers defend themselves?

“They say these are licensed pharmacies. These are licensed doctors. The responsibility should be with the boards that licensed those two groups,” Eyre said.

5. This investigation looked at the time period of 2007 – 2012. What’s happened since then?

On many levels, there’s been a crackdown on illegal use of prescription opioids, Eyre said. Hydrocodone was reclassified to make it harder to prescribe. State officials are tracking prescriptions more closely.

The number of overdoses from hydrocodone and oxycodone have leveled out and maybe declined a bit. But they’re being replaced by drugs like heroin and fentanyl.

6. What’s the relationship the flood of pain pills and today’s heroin epidemic?

“The pain pills set the stage,” Eyre said, for illegal drugs like heroin and more powerful synthetic opioids like fentanyl.

Now, those drugs are causing more and more overdoses.

7. What’s been the reaction to your story?

“Since this article came out, I have gotten emails from all over the country, saying they had an overdose in the family,” Eyre said.

“The other set is lots of emails from people who grew up in West Virginia, and worry about the state.”

8. What’s the historical context?

Front Porch co-host Rick Wilson says, “It reminds me of the Opium Wars, in which Great Britain went to war with China to have a free market in drugs.”

9. How did this even happen?

“When there’s a drug epidemic in a poor community, it’s not that big a deal. But when it crosses over to affect middle and upper class people, it’s a tragedy,” Wilson said.

10. What Bible verse best sums up the lessons from this series?

From Wilson: Matthew 18:6 – “If anyone causes one of these little ones to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea.”

“The Front Porch” is a place where we tackle the tough issues facing West Virginia and Appalachia with some of the region’s most interesting thinkers.

WVPB Executive Director Scott Finn serves as host and provocateur, joined by Laurie Lin, a conservative lawyer and columnist, and Rick Wilson, a liberal columnist and avid goat herder who works for the American Friends Service Committee.

Subscribe to “The Front Porch” podcast on iTunes or however you listen to podcasts.

An edited version of “The Front Porch” airs Fridays at 4:50 p.m. on West Virginia Public Broadcasting’s radio network, and the full version is available above.

Share your opinions with us about these issues, and let us know what you’d like us to discuss in the future. Send a tweet to @radiofinn or @wvpublicnews, or e-mail Scott at sfinn @ wvpublic.org

The Front Porch is underwritten by The Charleston Gazette Mail, providing both sides of the story on its two editorial pages. Check it out: http://www.wvgazettemail.com/

Your Zip Code Has More to Do with Drug Addiction than the Quality of Healthcare Does

Kristina “Breezy” Weaver lives in Wyoming County, which has one of the highest drug overdose death rates in a state that leads the country in drug overdose deaths. Last June, Weaver’s father died of a heroin overdose.

“He loved to tell stories,” Weaver told Jessica Lilly on a recent episode of Inside Appalachia. “I think I miss him a lot because of how carefree he would act. He would always lift me up because I was his baby girl.”

It turns out that location has a larger influence on one’s health and likelihood to become addicted to drugs than the quality of healthcare available in that area. Rahul Gupta, the West Virginia state health officer and the commissioner for the Bureau for Public Health, said that national research shows that instances of drug addiction don’t occur in silos.

“What matters to health is where they live, where they learn, where they play, where they pray, where they meet friends,” Gupta said. “Those communities where individuals live tend to dictate a lot more about the health condition both in terms of survival and quality of life.”

The five counties with the highest per-capita drug overdose-related death rates are concentrated in the southern parts of the state. All of them are coal-communities. According to a 2016 study by West Virginia University’s Bureau of Business and Economic Research, Boone, Mingo and Wyoming counties are three of six counties in the state experiencing an economic downturn similar to that of the Great Depression in the 1930s.

Those poor economies could be influencing addiction rates. A study by the Department of Health and Human Resources found that between 2010-2014, adults with incomes lower than $25,000 in counties with the highest drug overdose rates (Boone, Logan, McDowell, Mercer, Mingo, Raleigh and Wyoming) were significantly more likely to suffer from poor health, obesity, cardiovascular disease and depression than other counties did.

The difference between those counties with the highest overdose rates and the rest of the state was even greater for women with a high school degree or less.

“When we talk about the gender gap, it matters especially for women because the core structure of a family is a woman,” Gupta said. “In a lot of West Virginia families, it’s the woman who’s setting the cultural example of consumption and healthy habits.”

The drug overdose epidemic affects the entire United States, not just Appalachia. According to the Centers for Disease Control and Prevention, between 1999 and 2014, 165,000 individuals died of opioid-related overdoses. The number of opioid-related overdose deaths quadrupled between 2010 and 2014.

That’s taking a toll on families throughout the country.

In east Tennessee, Vince Brown’s son Michael Brown became addicted to prescription painkillers after an injury ended his baseball career. Three years ago, Michael attacked Vince in his home in Tennessee for refusing to give him money. Vince feared for the safety of his wife and granddaughter, who were also in the house.

“So I shot him, with no intention to hurt him. I just was trying to stop (him). But he died. My granddaughter, she knew what her daddy was doing, she just – it’s hard for an eleven-year-old to comprehend and accept that,” Vince told WOUT reporter Jess Mador. “She wrote on her bedroom wall, ‘I love my daddy.’ And that’s ok. Because I know she does. And she always will, and so will my wife, and so will I.” His story was featured in the podcast Truckbeat, and on Inside Appalachia.

More than half of opioid addictions today are caused by prescription painkillers. West Virginia has the highest per-capita prescription rate for opioids in the nation. Starting in January, doctors in West Virginia will be required to follow CDC prescription guidelines, which encourage doctors to prescribe opioid prescriptions as a last resort, and to thoroughly warn patients about its addictive nature.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

Report Finds Pill Mill Pharmacies Contributing to WV Drug Crisis

Earlier this week the Charleston Gazette-Mail published an investigative report about “pill mills” in southern West Virginia. These are pharmacies that accept and distribute extraordinarily large numbers of prescription painkillers. Some of the doctors who have sent patients to these pharmacies have since been indicted on federal charges related to drug trafficking and abuse.

Kara Lofton sat down with Gazette-Mail reporter Eric Eyre to talk about the current lawsuit surrounding the pharmacies and how they have fueled West Virginia’s drug epidemic.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

Drug Firms Seek Closed Hearing to Explain Pill Shipments

Prescription drug distributors being sued by the state are seeking a closed hearing to explain why they want to keep information about pill shipments secret.

The Charleston Gazette-Mail reports a Boone County judge on May 6 granted the newspaper’s request to unseal court records about prescription pain pill shipments to West Virginia.

The distributors were given two weeks to appeal that order to the state Supreme Court or settle the lawsuit in order to keep the pill shipment numbers under wraps.

Instead, the distributors filed a motion Wednesday to revise the judge’s decision, requesting a hearing that would be closed to the news media and the public.

The attorney general’s office and other agencies sued the drug distributors, alleging they helped fuel the prescription drug problem in West Virginia.

State Official Aims to Lower Prescription Drug Abuse

West Virginia Attorney General Patrick Morrisey plans to purchase incinerators for the disposal of unwanted and expired prescription medication in a state that leads the nation in the rate of overdose deaths.

Morrisey announced the move Tuesday as part of an initiative to reduce prescription drug use in West Virginia by at least 25 percent.

According to Morrisey’s office, the incinerators will cost $6,300 apiece, paid for by the attorney general’s Public Health Trust.

Morrisey also urged doctors to regularly monitor patients’ use of opioid drugs and asked pharmacists to verify the legitimacy of each prescription, patient and prescriber as well as the proper dispensing of medications. The proposal doesn’t involve seriously or terminally ill patients.

Morrisey says West Virginia had nearly 700 drug overdose deaths last year.