The state of Montana has sued the two leading distributors of narcotic opioids in Montana, alleging the companies played a significant role in fueling the state’s opioid crisis, specifically at the height of the epidemic from 2006 to 2014.

The McKesson Corp. and Cardinal Health Inc. allegedly failed to monitor the number of opioid pills distributed in the state, according to a press release from the Montana Department of Justice. By law, distributors must stop shipments of suspiciously large or increasingly frequent orders and report them to state and federal authorities. But according to the lawsuit, both distribution companies failed to do so on orders shipped into Montana between 2006 and 2014.

Montana Attorney General Tim Fox, who filed the lawsuit on Monday in the Lewis and Clark County District Court, said in a prepared statement that opioids have had a “particularly acute impact on rural areas,” adding that the increased volume of opioid prescribing and distribution “correlates directly” to skyrocketing addition, overdose, and death in Montana as well as an associated rise in heroin and fentanyl abuse.

During the eight-year period, McKesson and Cardinal alone distributed more than 432 million opioid pills at 10 milligrams per pill to Montana, or more than 400 pills for every man, woman and child in the state. That figure accounts for approximately 63% to 68% of the opioids shipped into the state during that time-frame.

The epidemic, according to the press release, has caused more than 700 overdose deaths in Montana since 2000, with 369 of those deaths occurring between 2011 and 2013. Opioids are the “most common substance associated with drug poisoning deaths in Montana,” with prescription drug abuse being 15 times more deadly than methamphetamine, heroin and cocaine combined, the release stated.

Montana has now joined several other states in suing the two companies. McKesson and Cardinal already have collectively paid West Virginia more than $120 million to resolve lawsuits.

“It’s time to hold these companies accountable for their reckless behavior, which puts profits ahead of public safety and fed our current wave of addiction and diversion, killing hundreds of Montanans,” Fox said.

The effects of the opioid epidemic have been long-lasting and can be felt in every corner of the state. And according to data released by the U.S. Drug Enforcement Administration in 2019, Lincoln, Flathead and Lake counties were collectively distributed some of the highest volumes of prescription pain pills in the state from 2006 to 2014.

The Washington Post published the bulk of the data on a searchable platform that shows nearly 328 million legally prescribed prescription pain pills were supplied to Montana during that time. Of these, the three counties saw more than 62 million pills, with Flathead County being supplied more than 41 million pills.

During the eight-year stretch, McKesson Corp. distributed the most to the three counties, at more than 25 million of the 62 million pills, and Cardinal Health distributed the second-most at about 13 million.

Last August, state officials and local medical professionals spoke with the Daily Inter Lake about why they believe so many pills saturated the northwest corridor of the state during the height of the crisis. One medical professional said the area has a large number of people who typically need chronic painkillers, including people on disability, veterans, elderly residents and others.

For example, Flathead County is one of the fastest-aging counties in the state, with about one quarter of the current population being 60 years of age and older. And in neighboring Lincoln County, a high population of disabled individuals historically have called the area home.

Aside from chronic painkillers being supplied to those who may need them most, several sources said the issue could be traced back to the early 2000s. At the time, drug companies were campaigning for doctors to prescribe long-acting pain medication to their patients at the same time pain was declared the fifth vital sign, or measurements taken to help assess the general physical health of a person.

“We [doctors] were being told by these companies that we were under-treating pain. The message was very pervasive,” one source said. “One of the questions patients were being asked was ‘how effectively did we treat your pain?’ and their answers had a lot of weight.”

Since the epidemic took off, however, Jon Ebelt, public information officer for the Montana Department of Health and Human Services, said multiple groups and organizations have come together to address the issue.

“We do know the issue of increased opioid overdoses has been well-noted; there has been more training around opioid prescribing, such as when to prescribe, how much to prescribe, proper disposal of medication,” Ebelt told in Daily Inter Lake in 2019.

According to Ebelt, Montana’s use peaked in 2009 and has “been declining ever since.”

Reporter Kianna Gardner can be reached at 758-4407 or kgardner@dailyinterlake.com