Eric Eyre - Death in Mud Lick: A Coal Country Fight against the Drug Companies That Delivered the Opioid Epidemic

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Copyright 2020 by Eric Eyre

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First Scribner hardcover edition March 2020

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ISBN 978-1-9821-0531-0

ISBN 978-1-9821-0533-4 (ebook)

To Lori and Toby

Pray for the dead, and fight like hell for the living.

Mother Jones

In two years, out-of-state drug companies shipped nearly 9 million opioid pain pills to Kermit, West Virginia, a town with 382 people. The quintessential coal town, split by a pair of railroad tracks, was the home of Sav-Rite Pharmacy, which once had the dubious distinction of being among the countrys top sellers of a highly addictive prescription painkiller called hydrocodonepackaged under brand names such as Lortab and Vicodin. Sav-Rite was the only game in town. The pharmacys owner, Jim Wooley, sold used cars on the side, right there in the gravel lot beside Sav-Rite. It was quite a racket.

Kermit didnt have nearly enough customers to buy that many pain pills. You could step into just about any pain management clinic in the county and walk out with a bogus prescription for $150. Wooleyhe pronounced it OO-LEEhad established a considerable footprint. Sav-Rites clientele would travel from hundreds of miles away, from Ohio, North Carolina, Tennessee, and even Florida. Word spread fast and far when a pharmacy would fill any prescription so long as you paid in cash. When folks started asking questions about Wooleys booming business in the middle of nowhere, he had a ready answer. His customers were mostly tourists, just passing through Kermit, on their way to hunt or fish or ride four-wheelers in the mountains. But it was Sav-Rite that had become the tourist destination. Cars and pickups were backed up, trying to squeeze into the drive-through lane, choking Highway 52 through town. Wooley was a salesman, through and through, and he recognized that a waiting customer wasnt a happy customer. So he dragged a camping trailer onto the parking lot and sold hot dogs and chips and soda pop out of it. The concessions were cheap, the customers were happy, and Wooley could make a few extra bucks outside the pharmacy to couple with the millions he was making inside selling opioids. To the tourists.

To keep pace with demand, he needed reliable suppliers. There was no shortage. One was McKesson Corporation. It ranked sixth in the Fortune 500. A couple of years back, McKessons CEO was the highest-paid corporate executive in the land. And the company didnt hesitate to fill Jim Wooleys round-the-clock orders. In 2006 and 2007, McKesson shipped 5 million hydrocodone pills to Sav-Rite, no questions asked. The following year, when Wooleys actions started raising suspicionshe opened a sham pain clinic up the road where addicts would pick up rubber-stamped prescriptions that only Sav-Rite would honorMcKesson, like a good corporate citizen, cut the pharmacy off. For two years. Once the authorities stopped snooping around, however, the global drug distributor resumed deliveries of hydrocodone and other powerful pain medications to Sav-Rite. But then Wooley got arrested for filling bogus prescriptions, and, well, that terminated the business relationship for good. It was lucrative while it lasted. McKessons CEO denied responsibility and faced no penalty. Wooley almost got off scot-free as well. Prosecutors recommended no prison time for the pharmacist-turned-entrepreneur.

Across West Virginia, other small towns like Kermit were also drowning in prescription painkillers. Thirty miles east, McKesson combined with wholesale drug giant Cardinal Healththe fourteenth-largest US companyand two regional distributors to deliver 16.6 million pain pills over a decade to a single drugstore in Mount Gay, which has all of seventeen hundred residents. Those same companies, along with AmerisourceBergenranked twelfth in the Fortune 500shipped 20.8 million prescription opioids to two pharmacies four blocks apart in Williamson, a town with twenty-nine hundred people, and only twenty miles from Kermit. Williamson was so overrun with painkillers that the locals started calling it Pilliamson. The white coats and blue suits made a fortune.

This was unbridled profiteering, yes, and it came with an undeniable public health cost. The pills were lethal. Take too many all at once, and you stopped breathing. People were taking hydrocodone and its more powerful cousin OxyContin, and they were accidentally overdosing in record numbers. Mingo County, where Kermit and Williamson are located, had one of the highest overdose death rates in the nation, according to the Centers for Disease Control. As the addiction crisis spread across the country, some health advocates sounded the alarm, but industry lobbyists snuffed out policymakers efforts to stop the scourge. They found politicians willing to do their bidding. The regulatorsthe DEA, the pharmacy boardfailed to do their jobs. Pablo Escobar and El Chapo couldnt have set things up any better. So the pills kept flowing, the number of deaths mounting. Federal laws and court orders kept the companies dark secrets hidden from the public. They left nothing to chance. It was all too big. And, truth be told, they almost got away with it, the biggest heist amid the biggest public health crisis in US history. Almost.

But there was something the corporate pill peddlers didnt forecast, something that took them by surprise: an unlikely alliance between an ex-con and the crusading lawyer who couldnt keep her out of jail. Starting in 2007, they slung accusatory stones up, up, up the drug supply chain, from doctors to pharmacists to drug distributors.

As a statehouse reporter with the Charleston Gazette-Mail, I stumbled into the middle of their legal battle in 2013, uncovering secrets and lies that set up a collision course with three of Americas largest corporations. That summer, I received a tip that Cardinal Health had helped pay for the inaugural party of West Virginias newly elected attorney general, Patrick Morrisey. Cardinals lawyer had headed Morriseys campaign transition team, and Morriseys wife had lobbied for Cardinal in Washington, DC, pocketing millions of dollars for her K Street firm. The previous attorney generala twenty-year incumbenthad sued Cardinal on behalf of the citizens of West Virginia. Now, Morrisey, after Cardinals top executives helped bankroll his campaign, was overseeing the suit; lawyers close to the case contended he was trying to sabotage it. Morrisey insisted he had stepped aside from the lawsuit, but I unearthed letters showing he had met privately with Cardinal lawyers about it, and court documents and emails revealed he was giving staff specific instructions on how to handle the suit. In retaliation, Morrisey set out to derail my investigation with one of his ownagainst my employer, a tenacious small newspaper in financial peril. His benefactors were counting on him to slam shut the door. But after the paper successfully fought to unseal court documents that the drug distributors wanted to hide from the public, the attorney general handed over previously confidential records that showed the companies insidious pursuit of profits. Along the way, I wrote hundreds of stories about the devastation and misery that opioids had inflicted upon our state. I kept digging for answers, the smaller articles snowballing into the larger story of how it happened, how drug companies flooded small towns with millions of prescription opioids, and how they got caught. It all began with a seemingly unremarkable death in a place called Mud Lick.