BRATTLEBORO — Municipal leaders are debating whether to sue local mom-and-pop pharmacies for helping to raise the town’s opioid-overdose rate to the highest in the state.
“It’s uncomfortable to think that the town of Brattleboro would be suing our locally owned pharmacies, but I think we have an obligation to look at every piece of the puzzle,” Selectman Tim Wessel says. “It’s a chain of links from the doctor to the pharmacy benefit managers to the pharmacies. All along the line, everyone’s role has to be examined.”
Bennington was the first Vermont town and St. Albans the first Green Mountain city to join a current series of multi-district federal lawsuits against national drug manufacturers and distributors and big-box chain pharmacies and benefit managers.
The Brattleboro Selectboard, which may decide as soon as next week whether to add its name to a growing roster of communities, counties and states going to court, doesn’t understand why smaller pharmacies aren’t facing similar scrutiny.
“I think it would be morally reprehensible to exclude any local pharmacies,” Wessel said at a recent board discussion of the issue. “Even though I am a huge fan of our local pharmacies and any pharmacy that operates as a family run business, I think we have to look at the entire picture.”
According to records for the years 2006 to 2012, Brattleboro Rite Aid chain stores reported the most opioid dosage units in town at 2.7 million, with the locally owned Hotel Pharmacy second at 2.4 million, Walgreens third at 2 million and the locally owned Brattleboro Pharmacy fourth at 380,000 (the latter store’s lesser figure reflects the fact it opened in the fall of 2010).
The town is considering filing a case in hopes of curbing opioid use and recovering municipal money spent to deal with related police and public safety issues.
“If you’re the pharmacy and you’re getting a prescription from a doctor and your job is to fill it and give it to the patient,” Town Attorney Robert Fisher has asked the board, “is it as innocent as that, or are the pharmacies failing to do their duty to look at suspicious or fraudulent prescriptions?”
Staffers at the town’s two locally owned pharmacies say the issue isn’t so simple. They note the nation’s drugmakers introduced opioids at a time when authorities began to evaluate health care providers based on how well they managed patients’ pain, creating top-down pressure throughout the supply chain.
“The epidemic has a lot of contributing factors — it was the perfect storm,” says Casey Powers, a pharmacist at Hotel Pharmacy. “Over long periods of time, big specialty organizations have put forth recommendations that local practitioners were trying to honor. A lot of those efforts were misplaced and caused problems we weren’t thinking were possible.”
Hotel Pharmacy staffers have since attended a series of community meetings on the issue.
“It is an important conversation for the town to be having,” Powers says, “but in terms of a lawsuit, I wouldn’t think it’s fair to assign blame to local practitioners who at the time were trying to do their best.”
Brattleboro Pharmacy, the town’s other locally owned druggist, declined to publicly comment on the issue.
Brattleboro isn’t the only Vermont locality struggling with addiction and aggravators such as poverty and mental illness. But the town, the first exit off Interstate 91 and the nearest to the New England heroin-route hubs of Holyoke, Massachusetts, and Hartford, Connecticut, has seen opiate use skyrocket from 20 overdoses in 2010 to a state-high of upward of 100 and five resulting deaths this past year.
The Selectboard is scheduled to discuss the issue next Tuesday at 6:15 p.m. at the Municipal Center at 230 Main St. The town won’t have to invest any money and little time if it decides to pursue a case, as lawyers for the larger federal lawsuit would pay all court costs and receive 25% of any financial winnings.
Although the Selectboard is talking about suing local pharmacies, the businesses say they’ve yet to hear from members. Local leaders, for their part, don’t necessarily see the proposed action as problematic.
“I would hope that the locally owned pharmacies down the road would be exonerated in this process, which would be healthy for them in the long run,” Wessel said. “But to exclude locally owned from the CVS and Rite Aids seems hypocritical to me.”
Read the story on VTDigger here: Brattleboro may sue mom-and-pop pharmacies over opioids.