The Editorial Board

USA TODAY

Much of the responsibility for the opioid epidemic has been directed at Purdue Pharma, and not without good reason. Purdue introduced OxyContin in the mid-1990s and marketed it aggressively. Its sales representatives lied about its addictive qualities. Its executives downplayed reports of abuse. Its owners grew rich while thousands of people died and countless families were shattered.

But documents pried loose last month, thanks to legal action by The Washington Post and the Charleston Gazette-Mail, confirm that there is plenty of blame to go around for the opioid crisis, much of it falling on other drugmakers and distributors.

The data, compiled in the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System database, shows that from 2006 to 2012 America was saturated with an astonishing 76 billion prescription opioid pills — about 230 for every adult and child in the country.

Even as more people became addicted and deaths involving opioids skyrocketed (from 8,048 in 1999 to 18,515 in 2007 to 47,600 in 2017), more companies ramped up the business of making, distributing and dispensing generic forms of powerful painkillers such as oxycodone and hydrocodone.

Among drugmakers, Purdue actually ranked fourth (2.5 billion pills) in the ARCOS data. Leading the pack were lesser-known SpecGx, a Mallinckrodt subsidiary (28.9 billion), Actavis Pharma (26.5 billion) and Par Pharmaceutical (12 billion).

OPPOSING VIEW:DEA had the full opioid data, not the pharmaceutical distributors

If it sounds like the companies were dispensing dangerous drugs like candy or snack chips, well, they were. In one email exchange from 2009, a former Mallinckrodt national account manager, Victor Borelli, told a customer that 1,200 bottles of oxycodone 30 milligram pills had been shipped.

“Keep ’em coming!” the customer responded. “Flyin’ out of here. It’s like people are addicted to these things or something. Oh, wait, people are.” To which Borelli responded: “Just like Doritos keep eating. We’ll make more.”

Even as the carnage mounted, pharmaceutical companies kept making more pills and distributors kept shipping more. Leading distributors included McKesson (14.1 billion pills), Cardinal Health (10.7 billion) and AmerisourceBergen (9 billion). Walgreens supplied 12.6 billion pills to its pharmacies, and CVS sent 5.9 billion, ARCOS shows.

The companies maintain that they were, literally, just taking orders, within DEA-established quotas for controlled substances. But several of the largest distributors have settled federal charges that they failed to prevent and report suspicious drug orders.

The ARCOS data “confirms everything. The volumes are even greater than we thought,” says Greg McNeil, founder and president of Cover2 Resources, who lost his son Sam to an overdose in 2015. Drugmakers and distributors “blew off the requirement to report suspicious orders and have internal compliance departments. ... At the heart of it, it is about the money.”

Now comes the financial reckoning. In a landmark lawsuit pending in federal court in Cleveland, nearly 2,000 cities, towns and counties are accusing drug companies of recklessly distributing opioids amid mounting signs of a deadly epidemic.

The case bears similarities to the tobacco litigation of the late 1990s, which resulted in a $246 billion settlement over 25 years — much of which ended up being diverted to expenses having nothing to do with public health.

No amount of money can undo the damage the greedy opioid peddlers wreaked. The challenge ahead is to ensure that settlement money goes toward addiction prevention and treatment, not unrelated government spending or lawyers’ yachts.

By editorial page editor Bill Sternberg for the Editorial Board.

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