Abstract
The opioid epidemic that raged through the 2010s hit many parts of the country hard, but few as hard as the coalfields of West Virginia. For those less inclined to learn the geographic nomenclature of the Mountain State, the coalfields are roughly the counties south of Interstate 64 (I-64) and west of the West Virginia Turnpike. The coalfields themselves have a violent and tragic history, from the well-known Hatfield and McCoy feuds to the structural inequity of coal camps, the Mine Wars, Bloody Mingo, Matewan and Blair Mountain; the Buffalo Creek disaster; pollution and runoff; and mine explosions, including Upper Big Branch’s in 2010 where 29 were killed. Thus, the opioid epidemic was just the latest in a series of tragedies in the region. (And that is why the sense of Appalachian fatalism is so strong in many from West Virginia, including me.) But unlike the past, when Big Coal was the enemy in so many tragedies, this time, Big Pharma was to blame.
In Death in Mud Lick: A Coal Country Fight Against the Drug Companies That Delivered the Opioid Epidemic, Eric Eyre (Charleston Gazette-Mail) situates the epidemic in this exploitative history. Eyre is not the much-maligned parachute journalist from the New York Times or CNN showing up when something bad happens (when I worked at a competing newspaper in Charleston, we had a drinking game for such reporting; take a shot for every “hardscrabble people,” “coal-stained faces” or “quaint mountain town.”). Eyre has done the work, both in this book and in his career; he earned the 2017 Pulitzer for investigative reporting on the epidemic in the Gazette-Mail.
Eyre uses his own Gazette-Mail reporting, plus new research for the book, to retell the events that killed more than 5,000 West Virginians in the 2010s. He begins with the story of the Sav-Rite pharmacy in Kermit, a town of about 400 that received nearly nine million opioid pain pills in a 2-year span (2006–2007). Pills flooded into the coalfields faster than trains used to carry the bituminous out. Down the road, another nearly 17 million pills went to the town of Mount Gay, and a little farther, nearly 22 million went to Williamson.
In the opioid epidemic, the big villains are Purdue Pharma and the Sackler family as the manufacturers of leading opioid painkillers OxyContin and hydrocodone. West Virginia was the first state to sue Purdue and win (in 2004) for its pushing OxyContin onto rural doctors. But the state’s attorney general was criticized for the distribution of settlement payments, including a large sum to establish a pharmacy school at the private University of Charleston. But the heat of the crisis came later, and Eyre focuses on the big three of McKesson, Cardinal Health and AmerisourceBergen as the drug distributors that let pills flow unabated during about 2006 to 2010.
The book draws its title from the death of William “Bull” Preece, a volunteer firefighter in Kermit. Preece had gotten his prescriptions from a “pill mill” doctor in Marietta, Ohio, and overdosed and died in 2005; he had prescriptions filled at Sav-Rite. Eyre’s investigation here led him to uncover a string of underhanded dealings, crooked doctors, negligent distributors and gross miscarriages of justice. Lawsuits remain underway.
Eyre’s book would be useful reading in an investigative journalism course. It is not a how-to manual, but it is a masterclass look at how it is done right. Work like Eyre’s does not happen overnight, or without digging, dead ends and a little luck. Students would benefit from hearing the story in his words.
The book also includes a glance at the drama of the demise of the Charleston Newspapers Joint Operating Agreement, where the owners of the Gazette made several missteps in purchasing, diminishing and closing the rival Daily Mail, ultimately creating the joint publication branded Gazette-Mail. This case merits a study of its own another day.
Eyre’s journalistic work presents a compelling story of profound corruption and greed. It is a tale as old as West Virginia herself: the state’s dollars lining the pockets of the rich somewhere else, and her people being left with the burden of their grift.