Drug giant Cardinal Health shipped more than 241 million prescription opioid pills to West Virginia over five years - more than double the number of pills distributed by the next-largest supplier of painkillers to the state, according to U.S. Drug Enforcement Administration data cited in a state lawsuit.
Between 2007 and 2012, Cardinal Health shipped 85.5 million oxycodone pills and 155.6 million hydrocodone pills to West Virginia. That's 154 doses of hydrocodone for every man, woman and child in the state over five years, and 85 oxycodone pills for every person.
Cardinal Health distributed more prescription painkillers to West Virginia than 11 other drug wholesalers combined.
"That's an extraordinary number of doses of medication for a small state like ours," said Delegate Don Perdue, D-Wayne, a retired pharmacist. "This should have raised a red flag at Cardinal."
Oxycodone (sold commercially as OxyContin and Percocet) and hydrocodone (Vicodin and Lortab) are the most widely abused prescription painkillers, and contribute to more overdose deaths in West Virginia than any other drug. West Virginia has the highest drug overdose death rate in the nation, and the number of deaths climbed last year.
Former West Virginia Attorney General Darrell McGraw filed suit against Cardinal Health in 2012, alleging the company helped fuel the state's prescription drug problem by shipping massive quantities of pain pills to rogue pharmacies.
Attorney General Patrick Morrisey, who lobbied for two drug trade groups that represented Cardinal Health before he ousted McGraw, inherited the lawsuit when he took office in 2013. He later stepped aside from the case after the Gazette-Mail reported on his ties to the drug wholesaler. His wife, Denise Henry, is a lobbyist for Cardinal Health in Washington, D.C.
Cardinal Health's West Virginia prescription pain-pill numbers haven't been previously reported. The Gazette-Mail discovered the shipping totals - disclosed in an October 2015 court document - while researching other records last week that were filed under seal in Boone Circuit Court.
The state's lawsuit alleges a large share of Cardinal Health's shipments went to counties in Southern West Virginia, the region "most affected by the drug epidemic."
Over five years, Dublin, Ohio-based Cardinal shipped 8.8 million hydrocodone tablets and 1.8 million oxycodone pills to Logan County. Pharmacies in McDowell County, one of the poorest counties in the nation, received 3 million hydrocodone pills and 1.5 million oxycodone pills.
"Cardinal distributed much of the fuel for the prescription drug problem in this state," the lawsuit alleges.
Indeed, Cardinal Health pill shipments - 241 million hydrocodone and oxycodone tablets - dwarf those of other prescription drug wholesalers.
AmerisourceBergen, the nation's third-largest drug distributor, had the next-largest numbers with 118.9 million painkillers shipped between 2007 and 2012, according to DEA data cited in a separate lawsuit against that company and 11 other wholesalers.
McKesson Corp. follows with 99.5 million hydrocodone and oxycodone pills.
The wholesalers' pain-pill numbers were culled from a DEA database, according to filings by Morrisey's office.
On Aug. 8, the Gazette-Mail sent a Freedom of Information Act request to Morrisey, asking for copies of the DEA pill shipment data cited in the state's lawsuits against prescription drug distributors.
A week later, Morrisey's office said it would conduct a search and get back to the newspaper by Sept. 15.
Morrisey's office said on Sept. 15 that it was still searching for the records and now "anticipates" a response to the newspaper's FOIA request on Oct. 20.
West Virginia's FOIA law requires agencies to release records within five days or to deny the request.
In 2008, Cardinal Health paid $34 million to the DEA in response to allegations that the company failed to notify federal authorities about suspicious prescription drug orders. In 2012, Cardinal agreed to a two-year suspension of its license to ship controlled substances from a warehouse in Lakeland, Florida, amid allegations the company had improperly distributed pain pills.
A Cardinal spokeswoman did not respond to a request for comment last week.
Perdue said drug wholesalers like Cardinal Health should be held to a higher standard than most companies because they deliver a potentially dangerous and addictive product.
"This is not like you sold a broken toaster," Perdue said. "You're selling stuff that can break people. Drug wholesalers have not ever taken responsibility for this, but they're part of the [drug] supply chain, and as part of that chain, they should be cognizant of that responsibility."
In previous filings, Cardinal Health and other wholesalers have said total pain-pill shipment numbers can be misleading. The companies argue that their raw pill counts, and the percentage of sales of controlled substances, would put the records in better context.
Cardinal Health lawyers also argue that the West Virginia Board of Pharmacy would have revoked the company's license if it had done anything wrong.
For more than two years, Morrisey insisted he had stepped aside from the Cardinal Health lawsuit when he took office in January 2013. He later told the state's lawyer disciplinary board that he played a limited role in the case his first months in office and didn't establish a "permanent screen" from the lawsuit until July 2013. Morrisey has turned the case over to his deputies.
The lawyer board dismissed a complaint against Morrisey that alleged he had an "incurable conflict of interest" with the lawsuit against Cardinal Health and a separate case against a dozen other drug wholesalers.
Between 2007 and 2011, Morrisey lobbied for drug company trade groups on Cardinal's behalf, Morrisey acknowledged during an ethics investigation last year. He also has represented the drug firm as a lawyer.
Cardinal Health has paid Morrisey's wife's lobbying firm, Capitol Counsel, $1.4 million since Morrisey became attorney general, according to lobbying disclosure reports. His wife has lobbied for Cardinal Health on Capitol Hill since 1999. Cardinal Health also contributed $5,000 to Morrisey's inauguration party in 2013.
Reach Eric Eyre at
ericeyre@wvgazettemail.com,
304-348-4869 or follow
@ericeyre on Twitter.