CHARLESTON, W.Va. — A data expert testifying at a landmark opioid trial in West Virginia said Tuesday that the potency of prescription drugs sent to local communities increased over time, but the three large drug distributors being sued tried to discredit his analysis.
Cabell County and the city of Huntington argue that AmerisourceBergen Drug Co., Cardinal Health Inc. and McKesson Corp. created a “public nuisance” by flooding their areas with prescription pain pills and ignored the signs that the community was being ravaged by addiction.
While consultant Craig McCann of Washington, D.C., focused his Monday testimony on how many doses of hydrocodone and oxycodone were shipped to the area overall, The Herald Dispatch reported that he zeroed in Tuesday on specific pharmacies.
He compared the number of opiates sent to single pharmacies and three family pharmacies — Fruth, CVS and Rite Aid — at four stores each.
Charts showed that these pharmacies received opiates at a disproportionate rate compared to the U.S. average between 2006 and 2014. The single pharmacies received the drugs at an even higher rate.
More powerful opioids were sent to Cabell County as time went on, McCann said.
Morphine milligram equivalent, a doctors’ tool to compare different drugs, was used to make the comparison. Oxycodone’s potency is about 1.5 times that of morphine, for example, but they’re on the same level based on the morphine milligram equivalent.
AmerisourceBergen attorney Joe Mahady said McCann wasn’t an expert on medical needs or a doctor who could determine how many prescriptions should have been sent out across the country. He said McCann made his own calculations based on an equation he found online, not with information from the Drug Enforcement Administration’s pill data.
McCann said data shows AmerisourceBergen and Cardinal Health were responsible for about 98% of the 14.8 million hydrocodone and oxycodone dosage units sent to four Fruth Pharmacies in Cabell County.
Four Rite Aid stores in the county received 8.8 million units, and while the company sent 63% of the doses itself, McKesson sent larger, stronger amounts of the drug. Two-thirds of the shipments received by four CVS stores came from Cardinal Health, McCann said.
McKesson attorney Paul Schmidt and Mahady said the plaintiffs were focusing on the highest numbers from the data that support their case and changing the scales on graphs to make them appear more impressive.
The distributors said they asked the DEA for access to its pill data for over a decade. According to Schmidt, the companies were only granted access to data for the previous six months starting in 2018.
“The Big Three” have continued to placed the blame on the DEA for its lack of communication and the pill quotas it set, as well as a rise in prescriptions written by doctors.
Similar lawsuits have resulted in multimillion-dollar settlements, but this is the first time the allegations have wound up at federal trial. The result could have huge effects on hundreds of similar lawsuits that have been filed across the country.
Huntington was once ground zero for the addiction epidemic until a quick response program that formed in 2017 drove the overdose rate down. But the pandemic undid much of the progress.