The Washington Post - 21.10.2019

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MONDAY, OCTOBER 21 , 2019. THE WASHINGTON POST EZ RE A


ment Administration to lower the
annual opioid quotas for drug
manufacturers. Morrisey set
aside the effort after the DEA
launched reforms.
Morrisey has gone on to file
lawsuits against opioid manufac-
turers Johnson & Johnson and
Teva Pharmaceuticals. He also
sued Purdue, alleging the compa-
ny “dramatically increased its
sales force” to market and sell
opioids in West Virginia after the
2004 settlement.
In late August, Purdue negoti-
ated a tentative settlement to
resolve more than 2,000 lawsuits
filed nationwide by local and
state governments; the compa-
ny’s founding family would guar-
antee a $3 billion payment and
turn over ownership to a newly
created public trust.
West Virginia is among the
states that have signed on to the
proposed framework of a settle-
ment with Purdue, which filed for
bankruptcy last month.
Other lawyers around the state
have also filed suit.
In Charleston, attorney Booth
Goodwin has sued Purdue and
other drug companies in federal
court on behalf of grandparents
raising children who were born
exposed to opioids. More than
200 caregivers, he said, have in-
quired about launching cases.
Harrison, the caseworker, said
she wonders whether the law-
suits will produce meaningful
results.
“These companies came in...
they didn’t care about families or
children,” Harrison said. “It was
all money, money, money, and I
just hated that they looked at us
like an easy target. Unfortunately,
I think we were.”

Twenty-one children in six
years
In June at the courthouse in
Charleston, Monica and Robert
“Jr” Kinder prepared to adopt
their fifth child from the state’s
foster care system. They are
among thousands of caregivers in
West Virginia who have tried to
fill the gaps.
The Kinders have fostered 21
children over six years in a
sprawling house in Charleston
decorated with Christmas por-
traits and angel figurines. They
delayed vacations and a new roof
in favor of baby formula and
backpacks.
While her husband worked a
six-day-a-week job operating a
bulldozer, Monica said she took
opioid-exposed babies to physical
therapy and toddlers with rotting
teeth to the dentist for the first
time.
“Why am I doing this?” she
recalled once asking her hus-
band. She answered her own
question: “This is where my heart
is.”
In 2016, the Kinders adopted
four sisters whose family was
destroyed by drugs. To give them
a fresh start, the Kinders let the
girls choose new first and middle
names, which were made official
by a judge.
In the courthouse in Charles-
ton, the Kinders were about to
adopt an 11-year-old who chose
the name Lexi and came to the
hearing dressed in pink.
Monica hugged the family’s
attorney, Bob Noone, who had
completed 16 adoptions over two
days in four West Virginia coun-
ties. He sometimes flies himself
to distant corners of the state in
his 47-year-old Cessna 172.
Noone smiled at the Kinders
and motioned them inside the
courtroom. The judge called on
the Kinders to raise their right
hands. Lexi, sitting between
them, raised her hand for good
measure.
“Pink,” the judge said to Lexi
before granting the adoption, “is
my favorite color.”
The night before, Lexi asked
her dad whether he was going to
take time off from his job to
attend the hearing. The family
needed the money — the Kinders
receive $24 per day per foster
child.
He looked at Lexi and teased, “I
may not make it.”
The humor was lost on Lexi,
who did not smile. Instead, she
studied Monica, who only a week
earlier had raced to the hospital
to pick up another newborn with
no place to go.
“Don’t worry,” Lexi said quietly.
“I have Mom.”
[email protected]

Corio is a journalism professor and
Soule is a journalism student at West
Virginia University. Hooper is a jour-
nalism student at George Washing-
ton University.

Washington Post data editor Steven
Rich and researcher Alice Crites con-
tributed to this report, along with a
collaboration of student journalists:
Shayna Greene, Halle Kendall and
Arianna Dunham from GWU and Pat-
rick Orsagos, Anna Saab and Madi-
son Weaver from WVU. Professor
Mary Kay McFarland at WVU also
contributed to this report.

The law firm that led West
Virginia’s case received a far
smaller percentage of the settle-
ment — 13 percent for legal fees
rather than the 33 percent paid
out in the three prior cases.
“Under no circumstances was
that case going to be handled at
that level,” said deputy general
counsel Steven Travis with the
state attorney general’s office,
where Morrisey is still in charge.
State officials said they believe
the payout is the largest state
settlement of its kind against a
single drug distributor.
But William Ihlenfeld, a for-
mer U.S. attorney, said West Vir-
ginia should have demanded
more. Ihlenfeld helped negotiate
a 2017 federal settlement with
McKesson for $150 million, argu-
ing the company had failed to
report suspicious drug orders.
“I think the damage done by
McKesson in our state calls for
something much greater than
$37 million,” said Ihlenfeld, now
a state senator in West Virginia.
“The trial lawyer in me... you
want to get it in front of a West
Virginia jury and let them decide
what it’s worth. You roll the dice.”
When news of the agreement
broke, U.S. Sen. Joe Manchin III
(D-W.Va.) quickly denounced
Morrisey and Republican Gov.
Jim Justice, calling the settle-
ment a “sweetheart deal” that
“sells out West Virginia.”
“I can tell you how much dam-
age has been done to the state of
West Virginia,” Manchin told The
Post. “We haven’t even seen the
fallout for the children that have
been affected.”
Morrisey’s office defended the
settlement, saying that Manchin
was “asleep at the switch” when
he served as governor of West
Virginia from 2005 to 2010.
The two men are political ri-
vals: Morrisey ran against the
incumbent Manchin in a bitter
2018 Senate race and lost.
“Any criticism of the McKesson
settlement by Sen. Joe Manchin
III is particularly rich given the
record-breaking numbers of pills
he allowed to proliferate
throughout the state during his
watch,” Morrisey’s press secre-
tary, Curtis Johnson, said in a
statement.
Beyond the settlements, John-
son said, the attorney general’s
office has developed new technol-
ogy and launched best practices
for prescribing and dispensing
opioids. The attorney general’s
office also sued the Drug Enforce-

back of my head, you know? ‘I did
this. I did this,’ ” Williams said.
“When I see these kids, I know
they’re better off. But still.”
Williams went to work at one
of 10 emergency shelters run by
the nonprofit Children’s Home
Society of West Virginia, which
has provided tens of thousands of
days of shelter care to displaced
children.
In 2017, Crouch took the helm
of the state Department of Health
and Human Resources. He quick-
ly tapped into his agency’s budget
to hire about 50 more casework-
ers, pay signing and retention
bonuses and increase the
$27,000-a-year starting salary.
Lawmakers also provided
$64 million in new money.
“What we’ve done has helped,”
Crouch told The Post, “but we
have not done enough. It’s been a
wearing issue in many ways and
we’ve got to fix it.”

A fourth settlement brings
sniping
In May of this year, the state
resolved its fourth lawsuit, this
time against the nation’s largest
drug distributor, McKesson
Corp., for $37 million.
In a statement, McKesson said
the company “has continually
enhanced its expertise, processes
and technologies dedicated to
protecting the integrity of the
supply chain and preventing di-
version.”

commissioner, pressed to direct
money to foster care and to ba-
bies born exposed to opioids,
fearing that a generation of chil-
dren would suffer from the conse-
quences of addiction. He laid out
a response plan developed by
experts at West Virginia Univer-
sity, Marshall University in Hun-
tington and Johns Hopkins Uni-
versity.
Though the state provided
some support, Gupta said he was
disappointed that officials failed
to focus more on the needs of
children.
“The [settlement] money was
inadequate and the manner in
which the money was utilized
was insufficient for the needs,”
said Gupta, who would leave
West Virginia to become chief
medical and health officer for the
March of Dimes. “We argue in
courts that we need this money to
solve the problem, but after the
settlements, nobody looks back
and says, ‘What happened to the
money?’ ”
By then, Williams, the case-
worker, had quit her state job.
She had helped separate a dis-
traught 3-year-old from his moth-
er, who was abusing pain pills
and other drugs. The boy was the
youngest of nine, living with his
pocket-size Thomas the Tank En-
gine toy in a house with no heat.
Williams would remember
dozens of similar incidents.
“There was something in the

both cases when he was in office,
said the settlements were inad-
equate. “Each one of those cases
was worth $100 million,” he
said.
Cagle disagreed, saying the
cases were the “maiden voyage”
in the series of lawsuits that
would follow against opioid dis-
tributors. A jury trial and subse-
quent appeal would have been
risky, the attorney said.
After the deals were struck,
Cagle, under a protective court
order requested by the drug com-
panies, had to return or destroy
all company documents obtained
through the litigation. Cagle said
he loaded about 50 boxes of
records containing company
sales data onto a pickup truck,
took them to a client’s farm and
built a bonfire.
“We just burned the whole
damn thing,” he said.
In a statement, Amerisource-
Bergen said the request to return
private documents was “hardly
atypical” for a district court set-
tlement and that the DEA already
had access to much of the infor-
mation.
For the second time, the law
firms brought on by the state
received one-third of the settle-
ment money — $15.7 million of
the $47 million payout. State
lawmakers stepped in, directing
much of the rest to treatment
facilities.
Gupta, the former state health

Charleston Gazette reported at
the time that one of the lawyers
for Cardinal Health had run Mor-
risey’s campaign transition team
and that Morrisey’s wife had lob-
bied on behalf of Cardinal in
Washington, D.C.
Morrisey’s office said the attor-
ney general’s wife never worked
on West Virginia-specific issues
and that the Cardinal Health
attorney described in the news-
paper story was a private lawyer,
not an in-house counsel. Cardinal
Health declined to comment.
As the lawsuits advanced, the
state in 2015 got a critical break. A
regional supervisor with the
Drug Enforcement Administra-
tion provided a detailed account-
ing of pill shipments in West
Virginia, said Cagle, the attorney.
“We basically got a data dump
from the DEA,” he said.
For the first time, the state
learned the scale of the opioid
shipments: Distributors had
poured more than 780 million
oxycodone and hydrocodone pills
into West Virginia between 2007
and 2012.
“Mind-boggling,” the judge
would later say.


‘We have not done enough’


In January 2017, four years
after Morrisey took office, West
Virginia announced a settlement
with Cardinal Health and
AmerisourceBergen. Like Pur-
due, the companies admitted no
liability, with AmerisourceBer-
gen paying $16 million and Cardi-
nal Health $20 million. The
smaller distributors agreed to
pay a total of $11 million.
The settlements were an-
nounced days after reporter Eric
Eyre at the Charleston Gazette-
Mail, using drug shipment infor-
mation and other records, de-
scribed the flood of pain pills in
stories that would win a Pulitzer
Prize.
“We were pleased to have
reached a resolution with the
state of West Virginia in 2017 and
have remained committed to the
safe and appropriate delivery of
controlled substances,”
AmerisourceBergen wrote in a
statement to The Post.
In a statement released after
the settlement, Cardinal said,
“While the company denies the
state’s allegations, Cardinal
Health recognizes that the epi-
demic of prescription drug abuse
is a multifaceted problem driven
by addiction and demand.”
McGraw, who had launched


CLOCKWISE FROM TOP: While her husband works six days a week, Monica Kinder, left, shuttles children to schools and appointments. Lexi hugs
her mother before her adoption hearing in June. The Kinder family has fostered 21 children in six years. They’ve raised this 1-year-old since birth.

The opioid Files


Source: CDC and West Virginia Supreme Court of Appeals annual reports BRITTANY RENEE MAYES AND STEVEN RICH/THE WASHINGTON POST

Abuse and neglect cases in counties hit hard by pain pills
From 2009 to 2017, as pain pills flooded West Virginia, counties with the highest rates of opioid overdose deaths also
tended to see higher rates of child abuse and neglect cases. State officials say that more than 80 percent of children in
foster care have been affected by the drug epidemic.

Child abuse and neglect cases

WheelingWheeling

MorgantownMorgantown

ClarksburgClarksburg

Beckley

Charleston

Huntington

Parkersburg

Number of cases per 100,
children under 18

0 100 200 300 400 817

Opioid overdose death rate

WheelingWheeling

MorgantownMorgantown

ClarksburgClarksburg

Beckley

Charleston

Huntington

Parkersburg

Per 100,000 people
0 15 30 45 60 83

AVERAGE ANNUAL AVERAGE ANNUAL
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