Rural cities, towns and counties in West Virginia, Kentucky and Virginia with disproportionately high shipments of highly addictive opioids had the highest per capita death rates, according to newly released government data for the years 2006 to 2012.

During that time, there were 4.6 opioid deaths per 100,000 residents on average. But in the counties with the highest opioid distribution, the death rate was three to eight times higher than the national average, the Washington Post reported.

The counties received a disproportionate share of the 76 billion oxycodone and hydrocodone pills made by some of the largest pharmaceutical companies. Lawsuits waged by local governments in Appalachia place the blame not only on the drug makers, but also the distributors and pharmacies for not alerting pharmacies of the disproportionately high volume of pills for areas with relatively small populations.

“What they did legally to my state is criminal,” Sen. Joe Manchin III told the Washington Post. “The companies, the distributors, were unconscionable. This was not a health plan. This was a targeted business plan. I cannot believe that we have not gone after them with criminal charges.”

The Washington Post obtained and analyzed data from the Drug Enforcement Administration (DEA) that tracks where opioids were distributed and compared it with individual death records from the Centers for Disease Control and Prevention (CDC), and discovered that the highest rate of opioid overdose deaths were in counties where opioids were most prevalent.

The most dire example was in Norton, Virginia, a rural city of about 4,000 people. Drug companies distributed enough opioids there for every resident to have 306 pills per year. Government records showed that during the same time period, the per capita death rate in Norton was 18 times the national average.

“That number blows me away,” Norton’s mayor Joseph Fawbush said. “I believe the manufacturers misled the doctors. It is addictive and they were telling doctors it’s not addictive.”

Fawbush said the city of Norton has also been devastated with overflowing jails, a high percent of children needing to be raised by their grandparents, “and our court system and emergency services are strained.”

The DEA database was made public by a judge overseeing a lawsuit brought by nearly 2,000 local governments blaming drug manufacturers, distributors and pharmacies for fueling the opioid epidemic and causing overdose deaths and economic damages. It is the largest civil action in U.S. history.

Beasley Allen has an Opioid Litigation Team, which includes these lawyers: Rhon Jones, Parker Miller, Ryan Kral, Rick Stratton, Will Sutton and Jeff Price. This team represents the State of Alabama, the State of Georgia, and numerous local governments, as well as other entities in opioid multdistrict litigation (MDL). They also handle individual claims on behalf of victims.

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