CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

Answers sought on delivery of pills to Southern WV

The Herald-Dispatch - 2/6/2018

Ahead of congressional hearings scheduled for later this month, the U.S. House Committee on Energy and Commerce is seeking answers from out-of-state drug wholesalers on how small southern West Virginia towns were pumped with millions of pills.

In six years, drug wholesalers sent more than 780 million hydrocodone and oxycodone pills, equaling about 433 per citizen, while 1,728 West Virginians fatally overdosed on those two painkillers. That situation has sparked a House inquiry and about 200 lawsuits alleging the wholesalers, manufacturers, pharmacies and others were responsible for the nationwide opioid epidemic.

Nationwide, opioids killed a record number - 42,000 people - in 2016, according to the Centers for Disease Control and Prevention.

The congressional hearings on measures to fight the crisis will begin Feb. 26 to help develop laws aimed at fighting opioid abuse. The House Committee says data provided to it by the U.S. Drug Enforcement Administration raise questions regarding the distributors' efforts to monitor for and mitigate the diversion of controlled substances for nonmedical uses in the state.

Committee Chairman Greg Walden, R-Ore., said the upcoming hearings were vital to battling the opioid epidemic.

"The coming weeks will be critical as we work to address the epidemic in a variety of ways, in addition to continuing our rigorous oversight duties," Walden said. "It requires an all-hands-on-deck effort to put a stop to this scourge, and we remain committed to that effort."

According to letters sent as part of the inquiry to drug wholesalers Miami-Luken and H.D. Smith last week, the House Committee is asking why the increases were not flagged as suspicious and reported to the DEA.

DEA data showed in 2009 a retail pharmacy in rural West Virginia should be expected to send approximately 45,000 dosage units of oxycodone per year. For hydrocodone, 270,000 was the expected yearly dosage units in 2008.

Citing press reports, the committee said H.D. Smith distributed 13.7 million hydrocodone and 4.4 million oxycodone pills to West Virginia from 2007 to 2012 without submitting any suspicious order reports to the state until a 2012 lawsuit was filed by the state attorney general.

Tug Valley Pharmacy and Hurley Drug Co., located just four blocks apart in Williamson, West Virginia, received 20,827,260 hydrocodone and oxycodone pills from 2006 to 2016, according to DEA data received by the House Committee.

The pharmacies received 39,000 hydrocodone pills over a two-day period in October 2007. In 2009, H.D. Smith allegedly sent a combined total of nearly 5 million hydrocodone and oxycodone pills, or 1,565 per citizen.

The small town of Kermit, West Virginia - population of 406 - was at one point receiving nearly 4.5 million pills a year.

Between 2005 and 2011, Miami-Luken sent 6.3 million pills to the Save-Rite Pharmacy No. 1 and No. 2 in Kermit. DEA data indicate H.D. Smith shipped over 1.2 million dosages of hydrocodone to each pharmacy in 2008, more than four times what the DEA cited a rural pharmacy should receive.

In 2008, the pharmacies were provided 4.3 million hydrocodone and oxycodone pills. H.D. Smith sent more than 1.3 million, a 1,154 percent increase over the 104,380 pills it provided the previous year. Miami-Luken was responsible for 2.3 million of the pills.

Records indicate Miami-Luken sent 1,700 oxycodone pills on Nov. 16, 2009, and within days the pharmacies asked for an additional 1,900.

The owner of the Save-Rite business testified at a hearing for a violation of the Controlled Substance Act, admitting his pharmacy was dispensing controlled substances at a volume of one prescription per minute.

In 2009, at the small town of Oceana, West Virginia, Miami-Luken sent Westside Pharmacy 4,391,520 pills from 2008 to 2015, including 823,000 in 2011. H.D. Smith provided over 369,000 oxycodone pills to Westside Pharmacy in 2009, and nearly twice as much in 2010 at 625,000.

In 2009 H.D. Smith shipped Westside Pharmacy eight times the amount it should have expected to send by DEA standards. The next year, its shipments were nearly 14 times the expected rate. At one point, the company filled oxycodone orders at 600 times the rate of a Rite Aid drugstore eight blocks away, the House Committee said.

Westside Pharmacy reported it turned away at least a dozen customers daily due to supply and demand at its height.

An earlier report by the same investigator reported that about 72 patients of Dr. David Morgan, who practiced outside of the state, would make a four-hour commute to Westside Pharmacy to have their prescriptions filled. Morgan's prescriptions accounted for 30 percent of all oxycodone pills dispensed from Westside.

The House Committee received a photograph of a 2015 sign outside the pharmacy indicating they would no longer fill prescriptions by Morgan, but they continued to do so after.

Morgan's license was suspended in 2016 after a board found his practice was "a substantial danger to public health or safety," the letter said. A later news report showed Morgan was under investigation in the overdose deaths of 20 patients.

H.D. Smith supplied the Family Discount Pharmacy in Mount Gay, West Virginia - population of 1,779 - with over 1.1 million hydrocodone pills, or 635 doses per citizen, in 2008. The previous year it had provided just over 57,000 pills to the same pharmacy, which accounts for a 1,880 percent increase. At Colony Drug in Beckley, West Virginia, Miami-Luken sent more than 7 million hydrocodone and oxycodone pills over an 11-year period. The number of hydrocodone pills from Miami-Luken doubled from 65,300 in 2009 to 131,400 in 2010. The number of oxycodone pills doubled from 570,400 in 2010 to 1,151,600 in 2013.

In a three-month period starting in 2013, Miami-Luken sent the pharmacy 168,400 doses of oxycodone, including 16,800 pills in a five-day span.

A Miami-Luken review of the facility in 2013 uncovered no suspicious activity, but did note there may have been suspicious activity at an Oceana-area pain clinic where many of the pills were filled.

The House Committee asked for more information on the allegations, including statistics, letters and documents about its drug distribution. It also asks for information on company protocol regarding identification and cessation of suspicious orders. The deadline for the information is Feb. 9.