Pittsburgh Current Lit Writer
West Virginia was as ravaged by the opioid epidemic as it was by extractive industry, ranking first in the nation in drug overdose deaths. Opioids wrecked huge swaths of Appalachia, including Western Pennsylvania, as drugs flooded the region. Both here in Allegheny County and all through West Virginia, drug overdose deaths peaked in 2017 and though the numbers have dropped a bit, they remain considerably higher than the time before opioids hit the region like a bag of wet cement.
Even as I prepared to call veteran journalist Eric Eyre, I wondered if the Current should cover another book about opioids in Appalachia. Minutes after Eyre and I got off the phone, an email notification dinged. The toxicology report had just been released for the death of a 1-year old child in Sharpsburg — it showed a mix of heroin and fentanyl were the cause of death.
Eyre’s book, ‘Death in Mud Lick: A Coal Country Fight against the Drug Companies That Delivered the Opioid Epidemic’ (Scribner, 2020), goes right to the heart of how things like a 1-year old accidentally overdosing can even happen.
As a reporter for the Charleston Gazette, the paper of record for West Virginia, Eyre covered much of the opioid epidemic in real time, through deaths and investigations, legal battles and cover-ups. His comprehensive, fearless, and deeply humane coverage won him the 2017 Pulitzer Prize for Investigative Reporting.
“You can’t escape it. It’s everywhere around you,” Eyre said of his hometown which wears ugly scars from the crisis and continues to suffer.
“Today, I saw an obituary. A friend of my wife’s — her son overdosed. He had lived in London and Chicago and New York and LA, but didn’t get addicted to opioids until he came back to West Virginia. There’s always a story you hear, everywhere you go.”
Eyre covered the state government beat, which meant he covered everything from the legislature and the governor’s office, to the state agencies, one of which is the Attorney General’s office. It was in that capacity that he crossed paths with the legal battles going on with opioids in his state.
Eyre writes, “As the addiction crisis spread across the country, some health advocates sounded the alarm, but industry lobbyists snuffed out policymakers’ efforts to stop the scourge. They found politicians willing to do their bidding. The regulators — the DEA, the pharmacy board — failed to do their jobs. Pablo Escobar and El Chapo couldn’t have set things up any better.”
In clean, detailed language, Eyre takes the reader through his efforts to uncover records held by the AG’s office and the DEA, and the court battles undertaken on behalf of the Charleston Gazette and Washington Post, so that they could report accurately and comprehensively on the epidemic. There are the lawsuits. There are Congressional hearings. There are cozy relationships between elected officials, enforcement agencies and large corporations. There is a lot of sleeping at the switch.
He also tells personal stories that bring the book to life. Eyre describes the tiny coal town of Kermit (population 382), home to Sav-Rite Pharmacy, one of the nation’s top sellers of hydrocodone, where they served hot buttered popcorn and other snacks to crowds waiting for their scripts to be filled. You didn’t have to be a next-level investigator to see that something was up. But Sav-Rite and other pill mills like it operated freely for years.
The actual building was about quarter the size of a free-standing fast food restaurant, but Eyre’s recalls Sav-Rite as being the 12th biggest dispenser of hydrocodone in the country.
He also tells the story of life-long Kermit resident, Debbie Preece. Preece is a less-than-perfect protagonist. She has a checkered criminal past. She did some time. She also has a relentless courage, like an Appalachian Erin Brokovich. When Debbie’s brother Bull died from overdose, she didn’t take that lying down.
“She’s a firebrand. There’s no bullshit,” Eyre laughed.
Together with a local attorney, Preece fought back by suing doctors and pharmacists responsible for letting the spigot of opioids overflow the region. Neither she nor her attorney knew about drug distribution companies like McKesson, Cardinal, AmeriSourceBergen and Miami-Luken who had their hands in the mess, too.
If Eyre had written this as fiction, it would be too ridiculous to believe, but Debbie Preece camped out at a pharmacy and then followed the unmarked delivery truck on his rounds to various rural pharmacies. She tracked down the license number — that was the first time she heard of the distributors.
“None of us knew — I didn’t know. As far as I knew, Purdue Pharma put their drugs from their factory and shipped them direct to pharmacies,” Eyre recalled.
‘A Death in Mud Lick,’ is full of sharp reporting and story-telling. But is also infused with the kind of compassion and moral outrage necessary to understand how a man-made disaster like this one happens.