A newspaper investigation found that drug wholesalers shipped 780 million prescription painkillers to West Virginia over a six-year period.
The Charleston Gazette-Mail reported between 2007 and 2012, 1,728 West Virginians died from overdoses of hydrocodone and oxycodone.
The newspaper obtained shipping sales record sent by the U.S. Drug Enforcement Administration to West Virginia Attorney General Patrick Morrisey's office. The companies had tried to keep the sales numbers secret.
In a state of 1.84 million residents, the shipments amount to 433 pain pills for every man, woman and child in West Virginia.
Retired pharmacist and former state Delegate Don Perdue, D-Wayne, said the figures "will shake even the most cynical observer. Distributors have fed their greed on human frailties and to criminal effect. There is no excuse and should be no forgiveness."
Several wholesalers agreed to settle lawsuits filed by the attorney general's office, alleging that they shipped an excessive number of prescription opioids to West Virginia.
More than half of all pain pills shipped statewide from 2007 to 2012 were by the nation's three largest prescription drug wholesalers, McKesson Corp., Cardinal Health and AmerisourceBergen Drug Co.
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Records showed a disproportionate number of pain pill shipments and fatal overdoses occurred in southern West Virginia counties. Many of the pharmacies that received the largest shipments were small, independent drug stores or locally owned pharmacies.
Six counties, Wyoming, McDowell, Boone, Mingo, Mercer and Raleigh, ranked in the top 10 in the nation for fatal pain pill overdoses, according to data from the Centers for Disease Control and Prevention.
The newspaper reported that from 2007 to 2012, drug wholesalers shipped a declining number of oxycodone pills in small doses and more in stronger formulations.
Recovering addict Chelsea Carter works as a therapist at a Logan County drug treatment center. She recalled crushing, snorting and injecting OxyContin. One time, she consumed up to 10 doses of oxycodone, passed out and awakened with the needle still stuck in her arm.
"When they handcuff you, and you walk through the doors, and you're in an orange jumpsuit and they slam the doors behind you, that's when you wonder is two to 20 years worth it for one OxyContin?'' Carter said. "That's when I hit my knees and prayed, 'Lord, if you ever bring me out of this, I'll never touch another drug again.'"
She said she's buried a lot of friends from drug addiction.
"I don't want to bury another one," she said.
