A federal judge has ruled that the nation’s three largest drug distributors cannot be held liable for the opioid epidemic in one of the most ravaged counties in the country — a place where 81 million prescription painkillers were shipped over eight years to a population of less than 100,000, the New York Times reported. Judge David A. Faber of the U.S. District Court for the Southern District of West Virginia released the opinion on the July 4th holiday, almost a year after the end of a trial pursued by the city of Huntington and Cabell County, which were the focus of an Oscar-nominated documentary called “Heroin(e)” about the effect of the prescription painkillers. The fatal overdose rate in Cabell County increased to 213.9 from 16.6 per 100,000 people, from 2001 to 2017, according to the ruling. In absolving the drug distribution companies — AmerisourceBergen, McKesson and Cardinal Health — Judge Faber acknowledged the terrible cost on the county and the city, but added that “while there is a natural tendency to assign blame in such cases, they must be decided not based on sympathy, but on the facts and the law.” His decision points to the difficulty of determining responsibility for a decades-long disaster in which many entities had a role, including drug manufacturers, pharmacy chains, doctors and federal oversight agencies, as well as the drug distributors. Drug distributors generally fulfill pharmacy orders by trucking medications from the manufacturers to hospitals, clinics and stores, and are responsible for managing their inventory. Like other companies in the drug supply chain, distributors are supposed to comply with federal limits established for controlled substances like prescription opioids, and have an internal monitoring system to detect problematic orders. Lawyers for the city and county argued that the distributors should have investigated orders by pharmacies that requested addictive pills in quantities wildly disproportionate to the population in these small communities. But Judge Faber ruled: “At best, distributors can detect upticks in dispensers’ orders that may be traceable to doctors who may be intentionally or unintentionally violating medical standards. Distributors also are not pharmacists with expertise in assessing red flags that may be present in a prescription.”
