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Meet the opioid wholesalers who became middlemen for the heroin epidemic

February 21, 2020

— Meet the opioid wholesalers who became
middlemen for the heroin epidemic Many people began their journey into addiction
with pain pills such as Oxycontin and Vicodin, which they often acquired from disreputable
doctors or pain clinics. But when the street price of the pills became
too high and states cracked down on the pill mills, many of the addicted turned to heroin,
which was cheaper and even easier to get. — Five Cincinnati-area companies sued
On Tuesday, the city of Cincinnati became the latest jurisdiction to sue pain pill wholesalers
when it targeted three major ones — Cardinal Health, McKesson Corp. and AmerisourceBergen.
A day later, Hamilton County agreed to join that lawsuit.
In July, Clermont County declared the opioid epidemic a public nuisance and sued the same
three wholesalers. Five other Southern Ohio counties, including Brown and Adams, have
joined that lawsuit. The state of Kentucky says it plans to sue distributors, and the
state of Ohio is considering doing the same. The Omnicare sales figures come from a lawsuit
filed in March by the commissioners of Kanawha County, West Virginia, the home of that state’s
capitol, Charleston. It names 16 distributors, including five from
the Cincinnati region: Omnicare, Kroger, Springboro-based Miami-Luken, Masters Pharmaceutical Inc. and
Blue Ash-based Keysource Medical Inc. All the companies are part of a previously
obscure link in the chain of that supplied doctor’s offices and consumers with pain medicine,
and led — many experts agree — to addiction and heroin.
Carol Wagner’s son, Chad, died of a heroin overdose at the age of 37. His addiction started
with the painkillers Oxycontin and Vicodin, which a doctor prescribed for his carpal tunnel
syndrome. “He was a wonderful kid,” said Carol, who
lives in Fort Mitchell. “He went to the University of Kentucky, he played ice hockey for the
university. He was handsome, he was charismatic, he was hard-working. He was all the things
you would want in a child.” By the time he overdosed and died in a Cincinnati
halfway house on May 20, 2005, he had lost his marriage, his home and had filed for bankruptcy
because of his addiction. His mother says drug wholesalers and others
should answer for the drug epidemic. “We are in an opioid crisis,” she said. “People are
dying. They need to be held accountable.”But holding them accountable is not always easy.
At least two local wholesalers years ago attracted the attention of the U.S. Drug Enforcement
Administration, which tried to shut them down. One, Masters Pharmaceutical, has been under
investigation by the DEA for nearly 10 years. In 2008, the agency threatened to revoke the
company’s license to sell controlled substances such as pain pills, saying it violated the
law by selling the powerful narcotic hydrocodone to “rogue Internet pharmacies.”Masters employees
should have known that those orders were suspicious, the DEA said.
The company reached a settlement with the DEA, but by 2013, the feds again threatened
to revoke its license. Employees were still failing to detect and report suspicious orders
of oxycodone, better known by brand names Oxycontin and
Percocet, it said. The company had filled orders of millions of doses of those drugs
to eight “illegitimate pharmacies” in Florida and Nevada, the DEA argued.
Federal regulations require wholesalers to report to the DEA suspicious orders of narcotics.
These can include orders that are unusually large or are made too often. The agency requires
the wholesaler to investigate suspicious orders and refuse to fill them if they are suspect.
But “Masters employees frequently simply brushed suspicion under the rug by deleting orders
or paring them down and shipping them without reporting them to DEA,” federal judge Susan
Dlott ruled in a 2011 lawsuit. Masters employees also accepted “half-baked or implausible explanations
its customers supplied,” the judge wrote. Masters has fought the DEA’s enforcement at
every step and continued to sell opiates while its case has been under appeal. The company
operates distribution centers in Fairfield and Forest Park. Last week, a federal appeals
court judge in Washington, D.C. ruled against the company, clearing the way for the DEA
to suspend its license. But the company will stay in business because
the DEA approved a license for a new Masters facility in Mason in December 2016, even as
the previous case worked its way through appeals. Keysource Medical is a relatively small, independent
drug supplier operating out of just one facility in Blue Ash. But DEA investigators paint a
portrait of a company that played an outsized role in the pain pill wave that inundated
the country. Keysource specialized in generic hydrocodone
and oxycodone, which the DEA calls the most widely abused pills in the country. Although
it is a relatively small supplier, Keysource became one of the top wholesalers of pain
pills to Florida pharmacies, the DEA said. In a two-year period, Keysource sold more
than 59 million doses of oxycodone to customers in 40 states, the DEA said. The vast majority
of that — 78 percent — was sold to pharmacies in Florida, which was known as a haven for
pill mills, the DEA said.

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