The Palm Beach Post

Complicity of drugmakers has been too long ignored

- By Robert Gebelhoff Robert Gebelhoff is a Milwaukee, Wis.-based financial journalist. He wrote this for The Washington Post.

For years, the opioid crisis was described as one of negligence. In this narrative, doctors overprescr­ibed pills that shouldn’t have gone to patients, and pharmaceut­ical companies overzealou­sly promoted medication­s while playing down the risks.

But new reporting demonstrat­es how this version, as worrying as it sounds, might understate the role of drugmakers in the opioid crisis. The Washington Post and “60 Minutes” reported that some of the Drug Enforcemen­t Administra­tion’s most experience­d investigat­ors believed criminal charges were warranted against one of the largest pharmaceut­ical companies in the world, alleging that the company, McKesson Corp., did little to prevent huge quantities of addictive opioid medication­s from being diverted to illegal use by pharmacies that were, in some cases, knowingly supplying illegal drug rings.

In other words, this isn’t just a story of simple negligence; it’s a story about whether drug manufactur­ers and distributo­rs turned a willfully blind eye toward illegal drug traffickin­g.

Defenders of opioid painkiller­s often argue that these medication­s are essential to people with chronic pain and that the vast majority of opioid prescripti­ons do not result in addiction or abuse. Instead, they contend, the prescripti­on drug crisis is a myth and the real problems are more powerful, nonmedicin­al opioids such as heroin and fentanyl, which account for the lion’s share of over- doses in the country.

But to focus only on these facts lets drug producers off the hook. The National Institute on Drug Abuse has found that nearly 80 percent of all heroin users in the United States started with prescripti­on opioids.

The Post’s investigat­ion illustrate­s a distributi­on system in which pharmacies, drug manufactur­ers and even regulators and lawmakers all played some role — knowingly or not — in a chain that reached massive numbers of illicit users. McKesson was not charged with a crime — DEA investigat­ors who pressed for charges were overruled by the Justice Department in 2015 — and the company denied any “criminal intent or the vio- lation of any criminal law” in a statement to the Post. But DEA agents reported that the company failed to review orders of “suspicious activity,” according to documents obtained by The Post.

In one instance, McKesson supplied so much oxycodone to a single pharmacist in Colorado that the company not only filled his orders, it actively raised the limit that it had set for shipments of opioid painkiller­s to the pharmacy. Even though that pharmacist was selling as many as 2,000 pain pills a day — in a city with

This isn’t just a story of simple negligence; it’s a story about whether drug manufactur­ers and distributo­rs turned a willfully blind eye toward illegal drug traffickin­g.

38,000 people — McKesson didn’t report the activity until after the DEA opened a criminal investigat­ion against the pharmacist, who is now in prison for drug traffickin­g.

Even still, DEA lawyers opted not to pursue criminal charges or take administra­tive action against the company. Instead, they settled with McKesson — not even going so far as to take away the company’s accreditat­ion to distribute products in the states where its drugs ended up in the hands of criminals.

DEA has fined McKesson twice for its opioid distributi­on practices — a $13.25 million fine in 2008 and another $150 million in 2017. But McKesson, a Fortune 500 company, has revenues of almost $200 billion annually. More than $2 billion of that money is profit. The company’s chief executive alone has made $639 million over the past decade.

Demanding more action from the government is not meant to disrupt the lives of patients with pain. It’s to ensure that those who have been feeding the deadly addictions of our most vulnerable — while reaping hefty profits — are held accountabl­e.

This is not too much to ask. There’s an abundance of corpses and orphaned children across the country that tells us why.

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