Two Huntington pharmacies and their suppliers took center stage in the third week of a trial on claims the Big Three drug wholesalers fueled the opioids crisis by flooding Huntington and Cabell County with pills.
Defendants AmerisourceBergen Drug Corp., Cardinal Health and McKesson blame federal regulators, high rates of prescriptions by doctors and poor West Virginian health for the uptick in pills shipped here.
Attention shifted last week to SafeScript, a downtown Huntington pharmacy the Drug Enforcement Administration shut down in spring 2012 following the arrest of the drugstore’s owner. DEA drug database information said the pharmacy averaged 35,551 oxycodone dosage units a month from 2006 until its closure.
AmerisourceBergen said its system of checks and balances to prevent diversion of opioids into the illicit market exceeds regulations. Testimony showed, however, the firm could change its monthly pill shipment thresholds so it did not have to report a large order to regulators.
A 2009 memo showed a small pharmacy could order 350,000 hydrocodone or oxycodone pills a year; a mid-sided pharmacy, 760,000; and a large pharmacy, more than 1 million, without triggering a suspicious-order alert.
Steve Mays, AmerisourceBergen’s vice president of regulatory affairs, said regulation only identifies a suspicious order as one of unusual quantity, one that deviates from the usual pattern or one that is frequent.
Even today, there is no further guidance from the DEA on what is suspicious, May said.
After SafeScript’s closure, shipments of highly addictive opioids from Cardinal Health spiked at T and J Enterprises, doing business as the Medicine Shoppe in Huntington. A company email from Jesse Kave, a Cardinal Health salesman who also testified last week, said OxyContin sales were down at other pharmacies because doctors were switching to oxymorphone.
None of more than 1,000 orders triggered by a computer as possibly suspicious over three months combined was reported as actually suspicious after review.
Michael A. Mone, who worked in Cardinal Health’s anti-diversion branch, said the DEA neither complained about shipments to Cabell County nor alerted the company of wrongdoing by pharmacies there.
Cabell County attorney Mike Fuller cited Kave’s 2020 deposition in which he said the Medicine Shoppe had a “ton” of suspicious orders. Kave said he did not remember saying that.