Congressional report: DEA, drug distributors failed to stop flow of opioids into West Virginia

The Drug Enforcement Administration and some of the country’s largest drug distributors failed to stop a massive flow of opioids into rural West Virginia over the past 10 years, according to a new congressional report.

According to the bipartisan report, prepared by the House Energy and Commerce Committee majority staff, the distributors did not conduct proper oversight of their customers and failed to recognize potential red flags. Distributors transfer drugs from manufacturers to businesses such as clinics, hospitals, and pharmacies, where they can be dispensed to patients.

Those failures helped contribute to the worsening opioid epidemic in West Virginia, “the epicenter of the nation’s opioid epidemic and the state with the highest drug overdose death rate in the country,” the report says.

The report found that three of the country’s largest distributors did not question suspicious orders and did not monitor the volume of controlled substances sold to customers.

“The extraordinary volume of shipments in West Virginia was a signal of possible breakdowns in distributors’ oversight of their customers, including their suspicious order monitoring systems. Yet the actions taken by both distributors and the DEA contributed to — and failed to stop — this problem,” the report concluded.

West Virginia has the highest drug overdose rate in the country. Distributors, therefore, should have been keenly attuned to any red flags that came up when conducting due diligence on pharmacies across the state, the report said.

“Taken altogether, the Committee’s report outlines a series of missteps and missed opportunities that contributed to the worsening of the opioid epidemic in West Virginia,” the report said. “While focused on a narrow part of West Virginia, the report raises grave concerns about practices by the distributors and the DEA nationwide.”

The 18-month investigation found three companies — AmerisourceBergen, Cardinal Health, and McKesson — sent more than 900 million doses of hydrocodone and oxycodone to West Virginia between 2005 and 2016.

According to DEA analysis of market data, the hydrocodone disbursements to some pharmacies were as many as six times higher than the annual amount an average rural West Virginia pharmacy received.

The report also faulted the DEA for failing to effectively use a database that monitors the flow of controlled substances from manufacturers to sellers in real time. The agency could have used the database to investigate trends of pills being diverted to West Virginia pharmacies.

Instead, the data were used reactively to strengthen cases once DEA identified targets through other means.

In a statement, Cardinal Health commended the committee for the investigation, but noted that it is merely an intermediary and doesn’t manufacture opioids.

The company said it “will continue to implement rigorous anti-diversion controls and, as we have for over a decade, make a meaningful difference by raising awareness about the dangers of overprescribing and actively supporting efforts to address it.”

McKesson did not respond to a request for comment from The Hill.

In a response given to The Washington Post, the DEA said the agency has upgraded its software program so it can investigate suspicious opioid orders more proactively.

In a statement, AmeriSource Bergen said it "commends the House Energy and Commerce Committee for their comprehensive report and agree with and have proactively enacted many of the recommendations that are outlined at its conclusion."

Updated at 3:41 p.m.