STEVE INSKEEP, HOST:
A federal opioid trial centers on what drug distributors did to Huntington, W.Va. It's a city spread out for several miles along the Ohio River that was devastated by the opioid epidemic. That is, of course, true of many cities, which is why so many are watching this one trial. NPR addiction correspondent Brian Mann is also watching. He's in Charleston, West Virginia's capital. Brian, good morning.
BRIAN MANN, BYLINE: Good morning, Steve.
INSKEEP: What's at stake?
MANN: You know, tens of billions of dollars, potentially. I mean, this trial focuses on this one city, Huntington, in Cabell County, but it's really a test case. The outcome could show whether these massive corporations - AmerisourceBergen, Cardinal Health and McKesson - whether they're on the hook for helping clean up the opioid crisis nationwide.
INSKEEP: What did they do?
MANN: Well, what we know factually, Steve, is that these drug wholesalers kept shipping millions of opioid pills to pharmacies in Cabell County. West Virginia's attorney general, Patrick Morrisey, told me this went on for years, even after addiction rates and overdoses surged.
PATRICK MORRISEY: Absolutely outrageous, when you see the volume of pills that are flooding into these small communities, to assert that, you know, somehow you didn't know or, well, we didn't think it had to be enforced this way. This is in absurdity of that. Everyone knew.
MANN: And internal documents revealed during this trial do show these companies kept detailed records of the really astonishing volume of opioids they kept shipping.
INSKEEP: Yeah, and you've reported on this in the past - way more drugs than that small population would ordinarily have consumed in any reasonable fashion. What did the companies say to defend themselves, though?
MANN: Yeah, they say they did nothing wrong. There was testimony here yesterday from an executive named Michael Oriente, who oversees opioid shipments for McKesson, one of the companies being sued. Documents show he and other executives kept raising the amounts of opioids that pharmacies could order, but Oriente pointed out that McKesson told the U.S. Drug Enforcement Administration exactly how its safety monitoring system worked. And for the most part, he said, federal regulators allowed it to keep happening, and that's really the argument being made by the drug industry. They say they were just filling legal prescriptions with oversight from the government.
INSKEEP: Although aren't they having to confront in this trial evidence that suggests what they thought of their customers?
MANN: Yeah. There have been some embarrassing moments. One email chain made public during this trial showed top executives at AmerisourceBergen sharing a joke about people addicted to prescription opioids, calling them pillbillies (ph), talking about their hunger for hillbilly heroin, a reference to OxyContin. I was talking yesterday with Amanda Coleman, who runs a shelter for people in Huntington who are homeless and experiencing addiction, and she brought this up.
AMANDA COLEMAN: The utter disregard for lives here, the dehumanization of words like pillbillies - it's horrifying.
MANN: And one of AmerisourceBergen's executives was asked about this email during the trial. He said he regretted forwarding it and said the company does have an ethical culture. He described it as being of the highest caliber.
INSKEEP: If they're forced to do more than express regret, if they're forced to pay, what would the money go for?
MANN: People here in West Virginia say they hope their share of any payout would go to drug treatment and therapy programs. I spoke about this with Herb Dickerson (ph), who's been on and off opioids for years.
HERB DICKERSON: We need it. We need it. We're human beings. We're not animals. We just lost our way. We're just people looking for a help up.
MANN: So there's a lot at stake here, Steve, and we should know soon whether these companies are going to be forced to provide some of that help.
INSKEEP: Brian Mann, NPR's addiction correspondent, thanks so much.
MANN: Thank you, Steve. Transcript provided by NPR, Copyright NPR.
