A new report highlighted the way millions of opioids flooded small towns in West Virginia over a 10-year-period with ineffective government oversight.

Despite the fact that “inordinate volumes of opioids” were flowing into West Virginia between 2006 and 2015, drug distributors continued to fill outrageous orders, and the Drug Enforcement Administration took ineffective measures to enforce regulations that could have slowed the flow of opioids, according to a federal report released last week. 

The report, “Red Flags and Warning Signs Ignored: Opioid Distribution and Enforcement Concerns in West Virginia,” was prepared by House Energy and Commerce Committee.

It found that in 10 years, 20.8 million opioids were sent to pharmacies in the town of Williamson, which has a population of just 3,000. Another town, Kermit, which has a population of just 364 people, received 9 million. Overall, between 2007 and 2012, West Virginia pharmacies received more than 780 million hydrocodone and oxycodone pills.

“These troubling examples raised serious questions about compliance with the Controlled Substances Act (CSA), administered by the Drug Enforcement Administration (DEA),” report authors wrote. 

The report reviewed the practices of drug distributors, who are responsible for filling orders by pharmacies. Five companies, including the three largest in the country and two regional distributors, were reviewed. These were AmerisourceBergen Drug Corporation, Cardinal Health, Inc., H.D. Smith Wholesale Drug Co., McKesson Corporation, and Miami-Luken, Inc. 

The companies have a legal obligation to alert the DEA when they suspected that drugs were being diverted into illegal use. However, case studies reviewed in the report “raise sufficient concerns as to whether these companies fulfilled their legal obligations to prevent drug diversion.”

In fact, “the extraordinary volume of shipments in West Virginia was a signal of possible breakdowns in distributors’ oversight of their customers, including their suspicious order monitoring systems. Yet the actions taken by both distributors and the DEA contributed to — and failed to stop — this problem,” report authors wrote. 

The report also found that the DEA’s Automation of Reports and Consolidated Orders System, which is meant to help detect abnormal drug distribution patterns in real time, was not used to monitor distribution, but only to reinforce cases after they’d been flagged through other means. Additionally, the agency revoked the registration of fewer doctors and pharmacies thought to be contributing to drug diversion during the height of the pill crisis. 

Authors of the report said that the findings could help explain how the opioid epidemic unfolded across the nation. 

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“Taken altogether, the Committee’s report outlines a series of missteps and missed opportunities that contributed to the worsening of the opioid epidemic in West Virginia,” they wrote. “This investigation identified flaws limiting the effectiveness of the distributors’ compliance programs and DEA’s enforcement. While focused on a narrow part of West Virginia, the report raises grave concerns about practices by the distributors and the DEA nationwide.”

View the original article at thefix.com


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