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Robert C. Byrd United States Courthouse

The trial of the “Big Three” drug companies accused of fueling an opioid drug epidemic in Cabell County and the city of Huntington is taking place at the Robert C. Byrd U.S. Courthouse in Charleston.

An email released Friday in the federal trial pitting Huntington and Cabell County against three drug distributors showed McKesson Corp. employees cheering trends that showed Appalachians were shifting away from opioid pills to illicit drugs in 2012.

The email was sent among McKesson employees — first by Tracy Jonas, director of regulatory processes, who shared a February 2012 article that said the DEA was seeing a sharp drop in oxycodone sales in Florida.

“We are showing trends in other states where the addicts are moving to heroin and Meth. Ohio and Ky. for instance. I spoke to Jeff Conners of the DEA and he called it ‘Whack a Mole,’” Dave Gustin, a director of regulatory affairs, responded.

Jonas responded, “Good …let them move to heroin and meth …we don’t have to monitor that.”

“I was thinking that but didn’t want to verbalize it,” Gustin responded.

According to a 2020 federal court plea in Kentucky, this was around the time Gustin approved the shipping of 300,000 pills into a rural Kentucky pharmacy, a charge for which he pleaded guilty to a misdemeanor.

The email was released Friday after U.S. District Judge David Faber said he felt it was in the public’s best interest to share it after defendants attempted to block its release, stating Cabell County attorney Paul Farrell Jr. was attempting to illustrate his own story.

Huntington and Cabell County have accused the “Big Three” drug wholesalers — AmerisourceBergen, Cardinal Health and McKesson — of fueling the opioid crisis by sending excessive shipments of opioids into the area for eight years, before a reduction in the number of pills shipped made users turn to illicit drugs.

The defendants point to the Drug Enforcement Administration, doctors and West Virginians’ poor health as the culprits.

Also Friday, Dr. Lyn O’Connell, associate director of addiction sciences at Marshall Health, resumed her testimony to discuss the $2.6 billion “Resiliency Plan,” which details short- and long-term goals for Cabell County, centered around establishing an Addiction Science Institute to support and organize countywide efforts. The institute will facilitate research and education, and house other resources.

A governing board would be established to allocate funds, whether they come from this trial or grants. It will include representatives from the governments, Marshall University and other community leaders.

But the governments are still a ways off from being where they need to be, she said.

“The groundwork is there. It does feel to me we are standing on a solid foundation right now,” she said.

What Huntington and Cabell County don’t have right now is a transportation program for people who live too far away to get to services. Services also need to be expanded to be open at all hours if someone wakes up in the middle of the night and realizes they need help, she said. The municipalities also need ways to train and educate people, get the workforce ready and help those in recovery to pay court fines to regain their IDs and driver’s licenses.

O’Connell said the vast majority of these programs run on grants, which are unreliable and don’t give long-term funding. The grant for the Quick Response Team, for example, loses its funding at the end of June. To be able to continue on the path to recovery, the community needs its own funds.

“I worked on a grant until the night before I delivered [my baby]. That’s how important these are to get out,” she said. “We are constantly working on that. If we knew there was reliable funding, I can’t even imagine [where we would be].”

Steve Ruby, former U.S. attorney for the Southern District of West Virginia who now represents Cardinal Health, questioned O’Connell’s testimony, noting she did a radio interview recently during which she talked about the trial and said she thought the plaintiffs would get millions of dollars out of the case.

Ruby questioned if the wide-reaching Resiliency Plan calling for millions of dollars to abate the opioid crisis was an over-exaggeration to use at trial. Farrell, the lead attorney for Cabell County, was present at the first meeting that led to its creation, Ruby said.

Ruby said the first few draft estimates were much less than $2.6 billion. In the first draft, he said the institute was estimated to cost $172 million, but in a later draft, its cost had more than doubled to an estimated $365 million.

Through emails, Ruby attempted to show Farrell had interfered with the plan and requested they find a way to increase the amount of money sought.

Another attorney passed the blame to doctors who prescribed a high rate of opioid pills to Cabell County residents, pointing to previous presentations by O’Connell in which she had agreed they were a factor.

The trial will resume June 7.

Reach reporter Courtney Hessler at or follow @HesslerHD on Twitter.

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