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Opioid Trial

Plaintiffs’ attorney Paul Farrell Jr. enters the Robert C. Byrd U.S. Courthouse in Charleston on Wednesday for the third day of trial.

Accusers in a lawsuit alleging opioid wholesalers have fault in the Cabell County and Huntington drug crisis used a “heroine,” scientist, historian, social worker and health expert to stitch together pieces of a quilt they say will eventually explain how the area was left in carnage.

Huntington Fire Chief Jan Rader, who rose to fame for her role in the 2017 Oscar-nominated documentary “Heroine;” Dr. Corey Waller, an addiction medicine specialist; historian David Courtwright; Connie Priddy, program coordinator for Huntington’s Quick Response Team; and West Virginia’s former chief health officer, Dr. Rahul Gupta, testified about what they saw before, during and after 80 million pills were shipped to the area over an eight-year period starting in 2006.

The defendants said they reported suspicious orders to the Drug Enforcement Administration, but never heard back. They never knew when an investigation was happening.

They argued there is no way to know if the high level of overdoses in Cabell County were from illicit drug users or people using opioids as prescribed. West Virginians, who generally fail in every health category and face labor-intensive jobs, need opioids more for pain, they said. They blamed doctors and agencies for pushing high numbers of prescriptions for the high volume.

On the first day of trial, Waller said the brain knows no difference between legal and illegal opiates like heroin, hydrocodone or oxycodone, but they attach to receptors tighter and longer than natural opiates like endorphins, heroin the tightest. This causes dopamine levels to increase substantially, oftentimes leaving damage.

The brain is left injured and not able to reach the same high as before, which causes abusers to search for that same feeling, taking whatever they can find, he said, like heroin or other illicit drugs.

Courtwright said four major opium epidemics in the United States since the 1800s were patched by legislation. The Harrison Narcotics Tax Act regulated and taxed opioids in 1914. In the 1940s, the U.S. Supreme Court ruled against a direct sales company, stating they should have known the doctors did not need that amount of pills and should not have been shipping the large quantities, he said.

Congress continued to strengthen penalties for drug offenses after opiates made a comeback after World War II in inner cities. Eventually, the Controlled Substances Act of 1970 called for wholesalers to monitor, detect, investigate, refuse and report suspicious orders of prescription opiates.

Gupta, who is being eyed for a position as the nation’s drug czar under the Biden administration, called West Virginia “a canary in the coal mine.”

From 2001 to 2015, 7,209 residents died with at least one opiate in their system. Then the number skyrocketed. Cabell County accounted for 54.7% of the state’s heroin-related overdose deaths in 2015, with 163. That same year, Cabell County accounted for 41.3% of the state’s fentanyl-related overdose deaths, with 92. The number of the county’s deaths in 2016 (884) is more than four times the number of those who died in 2001.

Defense attorneys asked Gupta where in reports, bills sent to Congress, and other publications it was recommended that distributors change their policies, but he said it was not in the reports because it was beyond their scope.

Priddy, who doubles as a Cabell County EMS employee, testified to the declining mental health of EMS workers starting in 2017. They had unexplained anger and suicidal thoughts. Rader saw the same with Huntington firefighters.

In 2010, the Huntington Fire Department went on a total of 1,238 rescue calls. In 2017, the department went on 1,241 overdose calls alone. It was around 2012 when the number started to skyrocket, Rader said, and they began to see pill bottles at scenes.

Priddy said 90% to 95% of the Cabell EMS runs are opioid-related, but the QRT reaches 50% to 60% of overdose patients and 30% get into treatment.

They worked to get help for users, like the harm reduction program or requirements to carry naloxone, but the first responders themselves were forgotten for years as they watched overdose after overdose, death after death.

Recently the Compass Center and program opened for Huntington first responders to give them resources to help with better mental health, but most of its funding is from grants, which Priddy and Rader agreed was not sustainable. They need a permanent source to fund the programs so they can grow. The QRT money runs out June 30.

Dr. Craig J. McCann is expected to testify Monday on Automated Reports and Consolidated Ordering System (ARCOS) data, a database kept by the DEA pointing to where pills went from the time they were manufactured to when they were dispensed. Four witnesses for AmerisourceBergen and Scott Lemley, a crime analyst for the city of Huntington, are expected to follow throughout the week.

Follow reporter Courtney Hessler at Facebook.com/CHesslerHD and via Twitter @HesslerHD.

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