Is Bad "Self-policing" by Drug Distributors, CVS and Others Fueling Prescription Drug Abuse?

By Brian T. Lynch
(also see addendum below of 3/12/12)

Have you ever asked yourself how so many CVS and Walgreen pharmacies can survive in such concentrations in certain areas of the country?  How do they each make enough profit to survive?  An article in the March 1, 2012 Wall Street Journal may cause you to revisit these questions. 

The angle of the story, in typical WSJ fashion, is regulatory news that the DEA can enforce sanctions against a drug distribution corporation if they don't "self-police" to assure that Oxycodone and other addictive pharamcitucals aren't finding their way into the street.  A US District Court in D.C.ruling upheld that the US Drug Inforcement Administration's (DEA) has authority to halt shipments of prescription narcotics to Cardnial Health Inc., a drug distribution company in Lakeland, Florida.  The disturbing details behind the ruling are burried ten pages in the Corporate News section. 

It turns out that Cardnal Health is the second largest pharmacutial distribution center in the country with over $100 billion in revenue last year.  The DEA action arose when it was learned that Cardnal Health shipped a huge amount of Oxycodone to two CVS (Caremark Corp.) pharamacies in Florida.  At one CVS the shlpment of the drug to the store represented a nine-fold increase during 2009 with a 63% increase over that in 2010.  That represents more than two-million doses from just one CVS store, according to the WSJ.  Cardnal Health denied wrong doing and cited the success of it's "anti-diversion" program, which lead to "hundreds" of pharmacies that were denied product due to suspicious activity.  The company went on to point out that they don't "self-police" their larger buyers, such as CVS, because these corporations police themselves.  

The DEA papers didn't include proof that the drugs were illegally distributed.  Florida's Attorney General, Pam Bondi, did praise the DEA for their effors and said she wants Florida to loose the title of "pill-mill capital of the nation."  A congressional hearing of drug diversion is scheduled for today (March 2, 2012). 

According to the Wall Stree Journal, seven million Americans are using prescription drug for non-medical reasons.  In contrast only 1.5 million people are addicted to cocaine.  Deaths from pain killers have quadrupled in the past 10 years or so and surpass those from heroin and cocaine combined. 

So what is going on here?  It's time to turn our attention of the congressional hearings being held today to see what angle they take.


1. Addendum: Amazingly the House Judiciary Committee hearing (below URL) called only current legislators to speak on the topic, no outside witnesses.  Nothing of great substance was said with respect to interdiction of anti-diversion efforts.  The hearing is brief and can be seen following the below URL.

http://judiciary.house.gov/hearings/Hearings%202012/hear_03072012.html
Hearing Information

Hearing on: The Prescription Drug Epidemic in America Wednesday 3/7/2012 - 10:00 a.m. 2141 Rayburn House Office Building Subcommittee on Crime, Terrorism, and Homeland Security By Direction of the Chairman Hearing Documentation

2. ADDENDUM - I happened across this story today involving an example of where Cardinal Health has stopped selling narcotics to a small pharmacy due to unreasonably high volume of sales for the drugs involved. This bolsters Cardinal's claim that they do cut off sales to smaller pharmacies that appear to be selling too much of the drugs. It doesn't let the big pharmacy chains off the hook for not monitoring their own outlets or excuse Cardinal Health for not monitoring these chain stores as well as the independent pharmacies.

March 12, 2012
 http://oklahomacounty.kfor.com/news/news/92440-more-controversy-surrounds-pharmacy-scene-shooting

OKLAHOMA CITY -- There are some new developments in what has become one of the most notorious pharmacies in Oklahoma City. Reliable Pharmacy is located near Southwest 59th and Penn. Reliable was the scene of the shooting involving pharmacist Jerome Ersland several years ago.

That shooting eventually led to a conviction, first-degree murder, for Ersland.

Reliable was in the news again last week for an issue involving the potentially illegal sale of several well-known narcotics.

The company that supplies those narcotics, Cardinal Health, had tried to cut them off because they suspected Reliable Pharmacy wasn't doing enough to ensure those pills weren't entering the street drug trade.

The legal battle that is unfolding now involves two more heavy-hitters: Oklahoma County District Attorney David Prater and the Oklahoma Bureau of Narcotics.

The issue involves the distribution and sale of three controlled dangerous substances: Hydrocodone, Oxycodone and Xanex, sold under the generic name Alprazolam.

D.A. David Prater tells us, when it comes to those three drugs, Reliable Pharmacy sells more than four area pharmacies combined.  [more at the url above]