In September 2015, an employee of Rochester Drug Cooperative (RDC), one of the largest pharmaceutical distributors in the country, was preparing to review a report on the opioid drugs her company had sold to one of its pharmacy customers. Given the buzz in the office, she was steeling herself, as she put it in an email, to see “what evil lies within,” referring to evidence that her company’s highly addictive products were falling into the wrong hands. Despite the report, the company allegedly did nothing to stop that illicit flow of drugs.
That email text can be found within a criminal complaint against RDC filed in federal court this week — and you get a similar sense of dread as you read through the complaint. Given earlier revelations about the opioid epidemic, we knew there would be ugly allegations. Yet, the evil alleged in the document is still staggering, adding to the argument that the opioid epidemic was no mistake. Instead, it is the result of shocking complicity and greed.
The criminal complaint is a momentous development. It offers the first chance of seeing an executive in the drug distribution industry go to prison for his role in our overdose crisis. Prosecutors charged the New York company and two of its executives with three crimes, including conspiracy to distribute controlled narcotics for nonmedical reasons. The company does not dispute the charges, nor has William Pietruszewski, the company’s former chief of compliance, who has agreed to plead guilty and cooperate with prosecutors. The company’s former chief executive, Laurence F. Doud III, maintains his innocence, and his lawyer told The Post that he will “fight these false charges to his last breath.”
But the charges are breathtaking. Prosecutors say RDC’s executives were repeatedly warned by their staff that their products were being diverted to illicit markets on a huge scale. As early as February 2013, a contractor who conducted pharmacy audits for RDC advised management that the opioid products being dispensed to some of its pharmacy customers were “like a stick of dynamite waiting for DEA to light the fuse,” according to the complaint.
In the case described by RDC’s employee as potentially “evil,” the complaint notes, the company’s compliance staff had found that, between October 2013 and February 2014, 88 percent of that pharmacy’s oxycodone 30 mg sales were paid for in cash. Compliance employees also found that the doctors writing the most prescriptions for the painkillers were located in a different state from the pharmacy, and that RDC had identified other doctors on an internal “Watch List” for having engaged in suspicious activities.
And yet, prosecutors say, the company continued to fill those suspicious orders. Between May 2012 and November 2016, the complaint says, RDC fulfilled more than 1.5 million orders for opioids. During that entire period, it reported only four suspicious orders to the Drug Enforcement Administration.
It’s baffling to imagine that an executive could think he or she could get away with such alleged negligence, given that the DEA clearly notifies them of their legal responsibility to flag suspicious orders. But a few numbers offer some important context: In the time period that prosecutors investigated, RDC’s revenue from sales of controlled substances nearly quadrupled. In the meantime, the compensation of its then-chief executive, Doud, surged to $1.5 million a year.
The company, for its part, agreed to pay a $20 million fine over five years. And an RDC spokesman acknowledged in a statement that the company “made mistakes … directed by former management” that will have “serious consequences.”
For that frankness, we owe the company some gratitude. For too long, the public has seen the epidemic as the result of irresponsible doctors or the product of economic malaise. It may be true that doctors became too lax with their prescribing practices, but research has repeatedly shown that prescription drugs, under proper medical supervision, can safely manage pain without leading to addiction.
Why, then, did we have an outbreak in addiction? Because opioids were being taken without proper supervision. They were being diverted illegally to black markets. And, it seems, the largest conduit for that traffic, on a scale of tens of millions of pills, was right in front of us — through a corrupt pharmaceutical supply chain.
And it’s not just RDC that has faced such allegations. For example, McKesson Corp., the largest pharmaceutical distributor in the country, was similarly investigated for fulfilling highly suspicious orders of painkillers to pharmacists. McKesson was not charged with a crime (over investigators’ objections), but the DEA has fined it twice for its opioid distribution practices.
This is how prescription opioids flooded communities across the country, leading to heroin abuse and the fentanyl disaster we have today. This is the evil that was within.
We won’t solve our opioid crisis by putting drug executives in prison. But we might find hope in these small acts of justice. Perhaps such sentences will be the chemotherapy that begins to treat the whole drug supply chain’s cancerous complicity.