477 Pain Pills Per Person: Kentucky Sues Opioid Drug Company

A drug wholesaler flooded Kentucky counties with millions of prescription painkillers even as overdose deaths were on the rise, state Attorney General Andy Beshear charged in a lawsuit filed Monday in Franklin Circuit Court.

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By Bill Estep

A drug wholesaler flooded Kentucky counties with millions of prescription painkillers even as overdose deaths were on the rise, state Attorney General Andy Beshear charged in a lawsuit filed Monday in Franklin Circuit Court.

For instance, the company, McKesson Corporation, distributed 18.4 million doses of painkillers called opioids in Floyd County between January 2010 and the end of 2016 -- enough for 477 pills for every adult and child in the county, Beshear said.

The total was even higher per person in Perry County at 526 doses per person, Beshear said in the lawsuit.

Beshear argued McKesson engaged in unfair, misleading and deceptive business practices in distributing excessive amounts of pills, especially in rural Eastern Kentucky, and failed to report its distribution as required.

"McKesson knowingly and intentionally distributed enormous quantities of prescription opioids throughout Kentucky with total disregard for our health and safety," Beshear said in a news release. "This reckless behavior fueled our catastrophic drug epidemic that every community is facing."

The lawsuit said that in the time at issue, McKesson, which supplies pharmacies, had just under a third of the market share. In Floyd County, that means the lawsuit attributed to McKesson about a third of the 56.3 million doses of painkillers -- or more than 1,400 per person -- distributed from 2010 through 2016, the lawsuit said.

The company knew, or at least should have known, that much of the hydrocodone and oxycodocone it was distributing was being sold illegally and abused, the lawsuit argued.

"No responsible company would have seen these numbers and said all is well," Beshear said.

The lawsuit said that McKesson's practices broke state law and forced the state to spend extra money on costs such as substance-abuse treatment, prison and foster care.

"We are losing a generation; grandparents are raising babies; our jails are busting at the seams, and every level of local government is affected by this terrible epidemic," Floyd County Judge-Executive Ben Hale said in a news release from Beshear's office.

The lawsuit seeks an unspecified amount of money and an order barring McKesson from future false deceptive or unfair acts.

In response, McKesson said the accusation that the company fueled the opioid-abuse problem is unfounded. The company supplies orders, and has no means to drive demand beyond what is ordered, according to its statement.

"McKesson delivers life-saving medicines to millions of Americans each day and is committed to maintaining -- and continuously enhancing -- strong programs designed to detect and prevent opioid diversion within the pharmaceutical supply chain," the company said.

The allegations in the the new state lawsuit are similar to those in a complaint made by the federal government a year ago.

The U.S. Justice Department alleged in that case that McKesson failed to report suspicious orders for pills in Kentucky and other states, contributing to a spike in abuse of opioids.

The fact that the company did not report its pill orders as required likely meant more pills were diverted for illegal sale because federal authorities couldn't do proper monitoring, Carlton S. Shier IV, then acting federal prosecutor for the eastern half of Kentucky, said in January 2017.

McKesson agreed to pay $150 million to settle the allegations.

The settlement involved an investigation of a McKesson distribution center in Ohio by the U.S. Drug Enforcement Agency office in London; the U.S. Attorney's Office for the Eastern District of Kentucky, based in Lexington; and 11 other federal prosecutors' offices.

Federal authorities said McKesson agreed in 2008 to pay $13.25 million for similar violations, but had not fully followed the compliance program it put in place after the deal.

Dozens of counties in Kentucky and other states also are suing McKesson and other wholesale pharmaceutical distributors over claims that they improperly distributed painkillers that worsened problems with abuse and addiction.

Beshear announced in September that he would partner with four law firms to investigate and potentially sue drug manufacturers, distributors and retailers that contributed to Kentucky's opioid abuse epidemic.

The number of drug-overdose deaths in Kentucky hit a new high in 2016, when the state recorded 1,404 overdose deaths. The total number of Kentucky overdose deaths from 2012 through 2016, at 5,821, outstripped the total number of highway fatalities in the state by more than 2,000.

The painkiller oxycodone was detected in 19 percent of 2016 overdose deaths and hydrocodone was seen in 16 percent of cases.

(c)2018 the Lexington Herald-Leader (Lexington, Ky.)

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Caroline Cournoyer is GOVERNING's senior web editor.
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