Drug firms shipping millions of painkillers into Appalachia; closing pill mills isn't slowing deaths

Drug firms have been pushing prescription painkillers into pill mill pharmacies in the poorest and most rural Appalachian towns, where drug abuse and overdose death rates are among the nation's highest. Court records unsealed this week—stemming from a 2012 lawsuit by the West Virginia attorney general—show that "prescription drug distributors shipped large quantities of oxycodone and hydrocodone tablets to small towns like War, Kermit, Oceana, Van and Crab Orchard, supplying mom-and-pop pharmacies that filled prescriptions from doctors, some of whom were later convicted of federal crimes," Eric Eyre reports for the Charleston Gazette-Mail. (Pittsburgh Post-Gazette graphic)

Records show that from 2007 to 2012 "AmerisourceBergen, the nation’s third largest drug distributor, shipped 60.9 million hydrocodone pills and 26.6 million oxycodone tablets to West Virginia," Eyre writes. "That’s 33 hydrocodone pills and 15.5 oxycodone pills for every man, woman and child in West Virginia." Also, H.D. Smith shipped 12.4 million hydrocodone pills and 3.2 million oxycodone tablets, Masters Pharmaceuticals supplied 1.5 million hydrocodone pills and 859,000 oxycodone pills and Top Rx shipped 1.7 million hydrocodone tablets. "West Virginia spends more than $430 million a year on problems caused by prescription drug abuse, according to the state’s lawsuit."

Similar problems are found in neighboring states, such as Kentucky, which had 76 pain clinics in 2012, Van Ingram, executive director of the Kentucky Office of Drug Control Policy, told Rich Lord and Adam Smeltz of the Pittsburgh Post-Gazette. Melborne Williams, an Eastern Kentucky psychiatrist whose license was suspended, prescribed 1.35 million doses of the sedative Xanax in 2012, tops among the state's doctors, according to Kentucky's prescribing database. Danny Finley, coroner of Clay County, population 21,013, in 2012 classified 43 fatalities as drug-related. Finley told investigators that 11 of those deaths were patients of Williams.

Shutting down pill mills hasn't stopped drug deaths, Lord and Smeltz write. When states began making it harder to get prescription painkillers, drug users switched to heroin, which has become cheap and easy to get. Seven states analyzed by the Post-Gazette—Kentucky, Ohio, Maryland, Tennessee, Pennsylvania, Virginia and West Virginia—all saw a rise in fatal overdoses from 2010 to 2014. West Virginia leads the nation in drug deaths.