(COLUMBIA, S.C.) – Today, South Carolina Attorney General Alan Wilson announced that he has filed a lawsuit against three major opioid distributors for their part in the opioid crisis. This is the second phase of his deliberate approach to hold additional companies accountable for their role in fueling the epidemic. In his Complaint, the Attorney General alleges Cardinal, McKesson, and AmerisourceBergen violated the S.C. Unfair Trade Practices Act and created a public nuisance, and seeks injunctive relief and civil penalties. The Attorney General previously filed suit on August 15, 2017 against opioid manufacturer Purdue Pharma L.P., Purdue Pharma, Inc., and the Purdue Frederick Company.
“This lawsuit seeks to hold these companies responsible for their part in the opioid crisis,” said Attorney General Alan Wilson. “These distributors flooded the State with dangerously addictive drugs, devastating families across South Carolina.”
Opioid distributors, which purchase the drugs from manufacturers and sell and deliver them to pharmacies, have the legal duty of ensuring that all prescription medications are distributed properly and are not diverted for illegal use. Under South Carolina and federal law, these companies must monitor, investigate, report and refuse to ship suspicious orders of opioids. Until recently, these Defendants made almost no effort to do so, even shipping orders that were deemed suspicious.
“Unfortunately, there is no quick fix to the opioid epidemic. But this lawsuit against Cardinal, McKesson, and AmerisourceBergen is an important step in reversing the damage they have done to the public health and safety of our State. While we recognize that many South Carolinians have a legitimate need for opioid treatments, these companies did far more than merely distribute a legal product. Their failure to report and stop suspicious shipments of opioids into South Carolina resulted in tragic consequences to our communities,” Attorney General Wilson noted.
In the two years between the time the Attorney General filed suit against Purdue Pharma and this suit, the Attorney General’s Office has been part of a multistate investigation against opioid distributors. Based on information discovered as part of that ongoing investigation and additional, newly released data, Attorney General Wilson decided to sue these opioid distributors:
- Charleston County had the highest average distribution rate of pain pills per person per year of any county in the United States from 2006 through 2012. During this period, an average of 248.3 pills per person per year was distributed in Charleston County.
- In 2017, approximately 300,000,000 opioid pills were dispensed in South Carolina – nearly 60 times the State’s population.
- Between 2006 and 2014, these distributor defendants distributed the equivalent, at 10 mg per pill, of nearly 2.2 billion opioid pills into South Carolina. .
- During this same time period, South Carolina received the third highest concentration of pills per person per year of any state in the nation.
The impact of this flood of pills is equally alarming:
- As of January 2018, combined heroin and prescription opioid overdose deaths in South Carolina had exceeded the number of homicides in the state for three straight years.
- Between 2014 and 2018, the number of fatal drug overdoses involving opioids increased 62%, from 504 to 816.
- In 2017, 6,961 people in South Carolina were discharged from emergency and inpatient departments after receiving treatment for opioid overdoses or poisoning.
- From 2007 to 2014, South Carolina had 1,341 pharmacy robberies, the most of any state (Texas was second with 337 robberies) and 28% of total pharmacy robberies nationwide.
- In South Carolina, administrations of naloxone (or Narcan) to reverse opioid overdoses rose from 4,187 in 2015 to 6,427 in 2016. In Horry County alone, law enforcement and first responders used Narcan over 1,000 times in 2016. From 2013 to 2018, the State has seen a 110% increase in naloxone administrations by EMS personnel to reverse opioid overdoses.
The lawsuit alleges that McKesson, Cardinal and AmerisourceBergen have had systematic failures in failing to prevent diversion of prescription opioids in South Carolina and have all faced repeated sanctions. Given the massive volume of opioids they shipped into the state, these companies knew or should have known that the pills they were distributing were not being used for legitimate purposes, but being diverted to the black market. The complaint also includes the following allegations:
- The Defendants’ systems for monitoring, reporting, and rejecting suspicious orders were woefully inadequate. For example:
- The Defendants relied on inflated thresholds, or order limits, and then routinely adjusted or ignored those limits;
- Cardinal and McKesson failed to conduct oversight of the chain pharmacies that purchased most of their pills;
- AmerisourceBergen took no action in response to an internal investigation recommending an overhaul of its compliance procedures
- The Defendants failed to take into account important measures of potential diversion, including the volume of opioids they shipped relative to an area’s population.
- The Defendants shipped suspicious orders and reported them to law-enforcement only after the fact;
- The Defendants failed to conduct any meaningful review of new customers or potentially suspicious orders;
- The Defendants failed to devote sufficient resources to prevent diversion.
- For example, Cardinal, a company of 30,000 people, tasked just three employees with responsibility for conducting due diligence reviews for its more than 20 distribution centers. A senior official later admitted that it was impossible to conduct proper investigations with this staffing.
The State’s complaint will be available on our website, www.scag.gov. Once on the website, click on this release and look for a link at the bottom.