Editorials

Painkiller profiteers should be held accountable

A sentence of 20 years to life awaits a Lexington man recently convicted in federal court of distributing narcotics that resulted in a death.

Thousands of deaths have resulted from the prescription drug industry’s distribution of narcotics in Kentucky and West Virginia in volumes so staggering that it had to have been obvious the shipments far exceeded any legitimate demand.

The rate of fatal opioid overdoses has quadrupled since 1999 in tandem with the near quadrupling of prescription opioid sales, while the amount of pain reported by Americans has not increased. From 1999 to 2014, more than 165,000 people died in the U.S. from overdoses related to prescription opioids.

And yet, except for some financial settlements and the criminal conviction of three Purdue Pharma executives, the industry has never been held to account.

Last week, a judge ordered the release of documents in a lawsuit brought by West Virginia Attorney General Patrick Morrisey against pharmaceutical distributors. As the Charleston Gazette-Mail reports, drug wholesalers flooded notorious “pill mill” pharmacies in tiny, poor places with hundreds of thousands of painkillers — in violation, says the AG, of laws and industry standards meant to guard against diversion of controlled substances.

The documents cover five years, beginning in 2007, when it was well known that opiates were devastating the region. Between 2007 and 2012, AmerisourceBergen, the third largest U.S. drug distributor, shipped 60.9 million hydrocodone and 26.6 million oxycodone pills into West Virginia, or 33 hydrocodone pills and 15.5 oxycodone pills for every resident. (Hydrocodones include Vicodin, Lorcet and Lortab. Oxycodones include Percocet, Percodan and OxyContin.)

Across the Tug Fork from Kentucky in Mingo County (population less than 30,000), AmerisourceBergen in 2009 supplied 149,000 hydrocodone pills, or 12,400 a month, to a single pharmacy. In Williamson, Mingo’s seat, wholesaler H.D. Smith distributed as many as 157,400 hydrocodone pills to a pharmacy in one month.

The companies insist the numbers are reasonable in the context of all drug sales, but that ignores opiates’ exceptional potential for addiction and death. They are classified as controlled substances overseen by the U.S. Drug Enforcement Administration, whose failure to control the deadly oversupply also merits examination.

In 2007 — 11 years after OxyContin debuted — an affiliate and three executives of its maker Purdue Pharma pleaded guilty to falsely claiming the drug was less addictive than other opioids. The company agreed to a $634 million fine, which was a record but pales against OxyContin revenues of $30 billion.

Now we learn that OxyContin’s main selling point, what justified its high price — 12 hours of pain relief, double cheaper competitors’ — also was a lie. The Los Angeles Times reports that the company knew patients were getting less than 12 hours of relief before the drug went on the market and responded by instructing doctors to increase doses in lieu of more frequent doses. Why? Without the claim of longer effectiveness, insurers would not have paid more for the drug. Higher doses increased the potential for addiction, overdose and death.

Purdue Pharma’s owners, the Sacklers, worth $14 billion, appeared for the first time on Forbes’ Richest U.S. Families in 2015.

Where they and others who profited from fueling an epidemic that brought heroin to millennials need to appear: Under oath before a congressional investigation.

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