Two newspapers have published data shining a light on the big pushers in the opioid epidemic that has killed more than 200,000 while flooding the nation with painkillers.
According to the Washington Post and the Charleston (W.Va.) Gazette-Mail, Big Pharma flooded the market from 2006 to 2012 with 76 billion opioids — primarily oxycodone and hydrocodone pills — killing 100,000 in that period. The volume of pills increased nearly 51 percent from 8.4 billion in 2006 to 12.6 billion in 2012.
By comparison, morphine, another leading pain treatment, averaged around 500 million pills annually.
A class-action federal lawsuit filed by nearly 2,000 cities, towns and counties against opioid manufacturers and distributors is being heard in federal court in Cleveland alleging 10 companies conspired to inundate the nation with opioids. Forty state attorneys general and tribal nations also have filed suit.
Three companies manufacture 88 percent of the opioids: SpecGx, a Mallinckrodt subsidiary; Actavis Pharma; and Par Pharmaceutical, an Endo Pharmaceuticals subsidiary.
The oft-sued and fined Purdue Pharma, which received Food and Drug Administration approval for OxyContin in 1995 while downplaying its addictive nature, has 3 percent of the market. It recently settled a suit with Oklahoma for $270 million.
Six companies distributed 75 percent of the pills led by the twice-fined McKesson Corp., No. 5 in the Fortune 500.
The Post and Gazette-Mail waged a lengthy legal battle with the drug companies, the Department of Justice and the Drug Enforcement Agency to access the DEA’s ARCOS “transactional” database — Automation of Reports and Consolidated Order System — detailing county-by-county opioid sales, including the manufacturer, distributor, prescriber and pharmacy.
Although the Justice Department and the Food and Drug Administration have fined drug manufacturers and distributors more than $1 billion, criminal changes have been rare.
The Post reported the Justice Department rebuffed the DEA, which wanted to pursue criminal charges against McKesson after its second instance of egregious violations.
In 2012, the DEA found McKesson was shipping suspiciously large orders to Colorado pharmacies, notably 2,000 pain pills per day to Brighton, pop. 38,000.
“This is the best case we’ve ever had against a major distributor in the history of the Drug Enforcement Administration,” said David Schiller, who subsequently retired as assistant special agent in charge of DEA’s Denver field division. “I said, ‘How do we not go after the number one organization?’
McKesson was fined $150 million.
The callous disregard for the common good was unearthed in emails in the lawsuit by local governments.
Victor Borelli, a national account manager for Mallinckrodt, who used the phrase “ship, ship, ship” to describe his job, had this January 2009 exchange with Steve Cochrane, vice president of sales for KeySource Medical, about a large oxycodone shipment.
“Keep ’em comin’!” Cochrane wrote. “Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are.”
Borelli responded, “Just like Doritos keep eating. We’ll make more.”
They made the most pills per person (2006-12) for West Virginia, 66.5, which had the highest opioid death rate; Kentucky, 63.3; South Carolina, 58; Tennessee, 57.7, and Nevada, 54.7.
Norton, Va., led communities with 306 pills per person — and an opioid-related death rate 18 times the national average of 4.6 per 100,000 — followed by Martinsville, Va., 242; Mingo County, W.Va., 203; and Perry County, Ky., 175.
Iowans got 563 million opioids — an annual average of 18.4 pills per person — from 2006 to 2012. Its opioid-related death rate in 2017 was 6.9 per 100,000.
The opioid pill total and annual average per person in the Courier’s circulation area (2006-2012) were:
Black Hawk: 22,959,690;
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An examination of the database for Iowa counties shows opioid prescriptions were, for the most part, highest where there were large hospitals and/or cancer treatment centers, as could be expected.
Companies have blamed the epidemic on overprescribing by doctors and pharmacies and on customers who abused the drugs.
The database, though, shows specifically where markets were flooded beyond reason. Too many companies knew those numbers, but shirked responsibility for higher profits.
Opioid deaths were down last year. Congress finally approved comprehensive bipartisan opioid legislation, while cities and states took aggressive action against Big Pharma, akin to tackling Big Tobacco. Comparing a massive oversupply of potentially fatal substances to consuming Doritos may prove exorbitantly expensive to the drug companies.
One question persists after perusing the database and documentation: Would criminal prosecution of irresponsible corporate executives have been an earlier deterrent to this tragic epidemic?