Report shows 1.6B doses of opioids shipped to Missouri from 2012 to 2017

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More than a billion doses of opioids flowed into Missouri during a six-year period, according to a report released Thursday by Sen. Claire McCaskill (D-Mo.).

The report — a product of the senator’s ongoing investigation into opioid manufacturers and distributors — shows that three pharmaceutical distribution companies together shipped 1.6 billion doses of opioids to the state between 2012 and 2017, contributing to Missouri’s raging opioid epidemic

“It’s staggering. Over six years we averaged 260 pills for every man, woman, and child in Missouri,” McCaskill said in a statement.


“The opioid crisis these pills have fueled is a failure of policy and oversight by the government and a failure of basic human morality on the part of many pharmaceutical companies and distributors — a failure that has destroyed families and communities all over our state,” she continued. 

The report details information McCaskill received from the “big three” pharmaceutical distributors — McKesson, AmerisourceBergen and Cardinal Health.

She notes that the companies each recorded revenue in excess of $125 billion last year, placing them within the top 15 companies on the 2017 Fortune 500 list. 

The companies have also “consistently failed to meet their suspicious opioid order reporting obligations” over the past decade, the statement says. In some cases, this has led to surrendering licenses for distribution facilities and paying escalating fines after Drug Enforcement Administration (DEA) and Justice Department investigations. 

Distributors, by law, are required to monitor and report suspicious orders of controlled substances to the DEA, but the report revealed that reporting varied widely. 

While McKesson and AmerisourceBergen both shipped around 650 million dosage units to Missouri between 2012 and 2017, McKesson reported 16,714 suspicious orders to DEA while AmerisourceBergen reported 224. 

“These divergent reporting results alone do not in any way indicate violations of the [law] by the companies involved, but they do highlight the importance of ongoing outreach from DEA to industry regarding legal obligations for distributor and manufacturer registrants,” the report said. 

The report recommends the DEA return to earlier standards for the use of immediate suspension orders (ISOs) — which allowed the agency to suspend the licenses of companies that were found to have lax compliance. 

According to the report, the DEA did not issue an ISO against a distributor or manufacturer between 2012 and 2017. 

The DEA did issue an ISO to a wholesale distributor in May — it’s first since 2012.

The use of ISOs was the subject of a bombshell Washington Post and “60 Minutes” investigation that ran last year, which detailed a 2016 law passed by Congress that made it difficult for the DEA to use ISOs. 

McCaskill has introduced a bill that would repeal the law.

More than 3,400 Missouri residents died between 2012 and 2016 due to opioid-involved overdoses, the report says. 

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