How Painkiller Pushers Took Over Coal Country

One woman started the pushback against the pill dumping. After her brother’s overdose from opioids, Debbie Preece began asking questions about Sav-Rite. She got help from a sympathetic lawyer, and later from Eyre, who drove through the state’s towns and hollows in his Honda Civic.

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As the book moves forward, Preece learns she has cancer and plays a smaller role. Eyre learns he has Parkinson’s disease. The accounts of his tremors and other symptoms form a kind of shadow narrative to the main one.

Eyre charts the human toll of opioid addiction. The path to dependence, he writes, “often started with a car wreck or a mine accident, and a referral by workers’ comp to a rehab center or pain clinic, places with names such as the Wellness Center and Mountain Medical and Aquatic Rehabilitation.” People “complained of bad backs, torn shoulders and busted knees, and they found doctors and nurses to write prescriptions for hundreds of pain pills and, for good measure, anti-anxiety medication to help take the edge off. It sure did. And before they knew it, they were hooked.”

Pharmacies in West Virginia filled more prescriptions per capita than any other state. “Overdose death rates had quadrupled,” Eyre writes. “The drug crisis was costing the state $430 million a year — babies born addicted, families destroyed, skyrocketing jail bills, hospital emergency rooms overrun.”

This book quickly moves past greed-addled pharmacists and doctors to take aim at bigger fish, notably drug distributors like Cardinal Health, which sent more pain pills into West Virginia than any other company.

Eyre calls the addiction crisis “a man-made disaster fueled by corporate greed and corruption.” Cardinal “saturated the state with hydrocodone and oxycodone — a combined 240 million pills between 2007 and 2012. That amounted to 130 pain pills for every resident.” He writes: “The coal barons no longer ruled Appalachia. Now it was the painkiller profiteers.”

In a book with many villains, one stands out: Patrick Morrisey, West Virginia’s Trump-loving, trash-tweeting, non-loyalist-purging attorney general. Eyre recounts how Morrisey tried to derail his investigation into Cardinal Health, and meddled with an important lawsuit against the company. This was while Morrisey’s wife was lobbying for Cardinal and he had his own ties to the company.