It has become a frequent headline in newspapers and on t.v. news: Americans found slumped over the steering wheel or found at home, dead from an opioid overdose. In August, 174 people overdosed on heroin over 6 days in Cincinnati. In those cases, most had used heroin laced with carfentanil, a fentanyl derivative that is used for tranquilizing large animals, such as those kept at a zoo. So how do regulated prescription drugs such as these end up in the hands of those who can abuse them?
This past December, the CDC released data that showed opioid addiction is here to stay in the United States. In 2015, 52,000 people died from an opioid overdose and more than half of these tragic deaths were caused by a legally prescribed or illegally obtained prescription. With all the regulations in place for prescription drugs in the U.S., one has to assume that there is a failure somewhere in the distribution system. How else could it be possible that 33,091, or 63%, of all opioid deaths were due to prescribed medicines?
A Trickle Down Effect
Just two weeks ago, McKesson Corp., who touts themselves as being responsible for the delivery of ‘one-third of all medications used daily in North America,’ was ordered to pay a $150 million fine for failing to report suspicious activity to the Drug Enforcement Agency (DEA). In December, Cardinal Health agreed to pay $44m in federal fines, followed by a $20m agreement in January with the State of West Virginia.
It is required by law for drug distributors such as McKesson Corp & Cardinal Health to report suspicious orders to the DEA. Ethically speaking, healthcare practitioners and pharmacists are urged to submit a tip to a law enforcement agency if prescription abuse is suspected. While most are quick to point a finger at physicians and other prescribers, there is a large problem happening at the top of the chain.
In December, the Charleston Gazette-Mail published a report that a West Virginia town with 392 residents had received enough hydrocodone pills from drug distributors over two years to ‘amount to 433 pain pills for every man, woman and child in West Virginia.’ McKesson Corp. & Cardinal Health, along with one other distributor, (AmerisourceBergen Drug Co) shipped HALF of the 9 million pills to the town.
While opioid addiction is a sad reality in this country, one can only hope that the recent crack down on drug distributors will increase reporting of suspicious activity to federal and state agencies. As with all fines and lawsuits, we can also only hope that these large settlements will send a message to all those contributing to drug addiction to think twice before acting negligently.