A Shuttered West Virginia Pharmacy Shows the DEA’s Role in Escalating America’s Overdose Crisis

The number of overdose deaths has increased in America during the current pandemic. This is due to the continual spread of synthetic opioids such as fentanyl, which was often mixed with the drugs supply in meth and cocaine.

The provisional data shows a record number of over 93,000 deaths from drug overdoses in 2020. This is a significant increase in the death rate which has been steadily increasing for two decades.

If this is considered a crisis in public health (which both politicians and the media do), then it would seem that the availability of opioid-treatment drugs would be of paramount importance to public officials. Kaiser Health News reports that instead of the Drug Enforcement Administration (DEA), they have been targeting pharmacies providing them. This is partly because it believes drug addicts will turn to them.

This is a predictable result of drug war. Kaiser reported that Martin Njoku, a West Virginia pharmacist was targeted by the DEA in Fayette county. Njoku started dispensing buprenorphine to his customers in 2016 under the names Suboxone and Subutex.

Buprenorphine, a prescription drug that can be used to treat chronic pain and opioid addiction, is effective in treating both acute and long-term conditions. Buprenorphine has a high addictive potential and is easily misused. The DEA was notified about Njoku’s prescriptions and rescinded his pharmacy’s license to dispense opioids and controlled substances.

Njoku fought against the revocation in federal courts. In 2019, a U.S. District judge Joseph R. Goodwin ruled the DEA hadn’t actually proved or shown that patients who purchased drugs from Njoku’s pharmacy were either abusing the drug or diverting it elsewhere. The DEA did not provide any evidence that buprenorphine had been misused, but instead relied on a variety of circumstantial evidence in order to shut down Njoku’s operation.

Njoku received a federal court ruling, but the many years of fighting were too much for him. He closed his pharmacy in April. There are now many options to purchase buprenorphine, which is not an effective strategy to decrease drug overdoses.

ReasonJacob Sullum, a journalist for the Associated Press, has written regularly about how federal efforts have only exacerbated overdose by targeting companies making prescription painkillers. The evidence suggests that prescription drug abuse isn’t the main cause of overdose. People who are denied Suboxone will end up seeking out alternatives. Many of these black market drugs contain fentanyl. This leads to deaths from overdose.

Suboxone overdoses are less common. Sullum noted that even though they abuse them, Suboxone users rarely overdose. Kaiser points out that recent research has shown that increased prescriptions for buprenorphine have not led to an increase in misuse. It is most common to divert these drugs to others users to lessen or prevent withdrawal symptoms in people who cannot get prescriptions.

Kaiser points out that the DEA’s attack on Njoku’s clinic was not limited to denying West Virginians buprenorphine. The drug is considered very valuable by both federal and medical authorities. However, only 20% of U.S. pharmacies stock it. Kaiser was told by a former West Virginia pharmacist compliance officer that the pharmacies fear being targeted and taken out of business.

Buprenorphine is only available from licensed pharmacies. The DEA takes orders and wholesalers control the pain meds each pharmacy can order. DEA attorneys actually argued for evidence that Njoku drug users were travelling long distances in order to receive their medication. Goodwin made clear in his decision how the DEA is responsible for this.

The DEA’s forced reduction in access to buprenorphine actually fuels drug overdoses. People who are unable to obtain prescriptions or get their prescriptions filled are resorting to the black markets for replacements. This is the final terrible irony in the DEA’s actions. The DEA also published all kinds of alerts and fact sheets about fake pills warning of the possibility of fentanyl being in these drugs in potentially fatal doses. It is true. They then say that only “safe medications” are those prescribed by trusted doctors and dispensable by licensed pharmacists. This ignores the fact that the agency makes it more difficult to obtain these safe drugs.