Drug companies shipped five million opioid doses to a town of just 400 people in one two-year period, a shocking reminder of the industrial nature of an addiction crisis often depicted as a matter of individual failings rather than systemic corporate profit-seeking.
Zooming out a bit further, the ratio of pills to people only gets even more ridiculous. The 400-person community of Kermit, West Virginia sits about 30 miles west of Stollings, a town of about 300 people. To drive between the two, a person must pass through relatively sprawling Mt. Gay-Shamrock, home to roughly 1,800. Thirty miles south of that, about 3,200 people call Williamson home. These four towns combined host fewer than 6,000 people. Yet a trio of drug companies dumped more than 130 million doses of oxycodone and hydrocodone into pharmacies there in recent years.
The numbers, cited by the House Energy and Commerce Committee in letters sent to the three companies on Thursday, come primarily from lawsuits filed by the West Virginia Attorney General. The five million pills Kermit got in just two years came from a company called McKesson, which may be unfamiliar to most Americans but is the fifth-largest company in the country. Cardinal Health, Inc. sold another 27 million doses to Williamson and Mt. Gay-Shamrock pharmacies from 2006 to 2016. Together with AmerisourceBergen, responsible for 90 million of the doses sent to the towns, the companies make up 85 percent of the nation’s drug distribution industry.
Journalists and local lawyers have been familiar with the scale of the over-supplying of drugs to these communities for years. The Charleston Gazette-Mail won a Pulitzer for a 2016 investigation that showed 780 million painkillers had been shipped into the state in just five years. Salon and Alternet also sent reporters to Kermit back in 2012. Wholesalers like McKesson and pill makers like Perdue Pharmaceutical have faced down lawsuits in West Virginia going back to the George W. Bush presidency.
But with opioid misuse now recognized as a crisis worthy of national attention, powerful eyes are combing backward through 20 years of history and resurfacing startling factoids. In popular understanding, addiction to pain pills has historically been treated as an individual failing: A person slides from one post-surgery prescription into a lifelong cycle of drug abuse, presumably because they lacked willpower.
But centering addiction on individual choices lets the systems surrounding pain management off the hook. Thursday’s letters from Congress aim to redress that narrative failure and bring the pill industry back into the spotlight.
It’s hard to miss the statistics on what opioid misuse is costing the country. Scientists now attribute upwards of 40,000 deaths per year to opioids and their closest chemical cousin, heroin. A 2016 study from the American Society of Addiction Medicine reported that two million people in the United States were addicted to prescription painkillers while nearly 600,000 more had a heroin problem.
But it’s been fairly easy to overlook just how much money is being made off of these addictions and deaths. McKesson’s annual revenues of roughly $190 billion come from a much wider array of products than just opioids, of course, but the drugs accounted for somewhere on the order of $3 billion in sales for the firm in 2015 according to Fortune. McKesson, which has repeatedly denied all wrongdoing in state and federal court, has gotten out of jail cheap. It settled a federal case for $150 million early last year and $13.25 million in a similar suit in 2008. That’s a rounding error next to multi-billion-dollar pill revenues year after year for decades.
Scrape down one level further in the deadly money-mill of prescription drug development and distribution, and the blood starts getting onto just about everybody’s hands. Yes, McKesson executives like CEO John Hammergen make the easiest targets — Hammergen alone took home about $400 million in pay and stock from 2007 to 2017 — but the behemoth firm is also linked to millions of working people’s financial well-being through the market-based retirement systems that have replaced traditional pensions since the Reagan era. Firefighters and schoolteachers in Oregon and Texas have part of their portfolios wrapped up in what’s best for McKesson. Vanguard, State Street, and Fidelity, three of the largest financial firms in the country and stewards to the retirement investments of tens of millions of working people, also hold roughly one out of every seven shares of all McKesson stock.