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Tipline Investigation: The Secret Rx War

When most people think about the war on drugs they think about empty smuggling boats on the beach and massive pot fields tucked away our back country. But KEYT NewsChannel 3 discovered there’s another battle being waged right down the street at your neighborhood pharmacy:

Melissa Biliardi ruffles through some papers and gathers her thoughts. She’s sitting at the kitchen table getting ready for her weekly radio blog show, Help 4 HD. This unassuming mother from Santa Maria has about 71,000 listeners and she is on the front lines of the drug war.

“We are here with Emily Rachel Fisher and welcome to the show, how are you tonight?” Biliardi announced as she started the broadcast. The topic every week is about Huntington’s Disease, how to fight it and how to live with it.

As Biliardi sits in a chair talking on the radio, her 33-year-old son James Birdsall plays on the floor behind her with his best friend, a small dog with a lot of energy, certainly more energy than James can muster.

James Birdsall

James has Huntington’s Disease and he is terminal. H.D. is a neurodegenerative genetic disorder that affects muscles and the brain. “I am going to fight this terrible and dastardly disease called Huntington’s and I’m going to do it with all my might, in my way, in my way,” Biliardi tells her listeners as tears begin to well up in her eyes.

She’s fighting for James and her other son, Raymond, who died in June shortly after he was diagnosed with Huntington’s. He was just 30-years-old. How he died is a mystery, but authorities have not ruled out suicide. Biliardi says too many people with Huntington’s kill themselves because they know the suffering they will go through. As for James, “He cries all the time, he’s in pain. he’s in excruciating pain.” Biliardi said. That’s why for the last six years or so James has been on a carefully structured regimen of the most powerful pain medications known to man and he says it’s been working.

But on June 16, pharmaceutical manufacturer, McKesson, cut off the Pain Management Pharmacy in Santa Maria where Biliardi would get the drugs that her son needs. Besides Huntington’s, James also suffers from Klinefelter’s Syndrome and diabetes. The drugs he took regularly until McKesson stopped its shipments included, Methadone 380mg/day, Atavan 12mg/day and Fentanyl TOFC of up to 2400 mcg/day for breakthrough pain. Biliardi says her son is allergic to some of the other pain medications that are often prescribed. “You can’t just cold turkey take them off of something like that, it’s gonna kill them” Biliardi said.

“I almost died from just weaning off my previous medications that they put me on. I don’t know what to do now. They’ve taken the only thing away from me that works,” said James as he sat in a chair and struggled to get the words out.

Why did McKesson stop its drug shipments? Scott Guess, owner of Pain Management Pharmacy in Santa Maria, says that a week before all of this happened, a McKesson senior official told him he was a finalist for their pharmacist of the year award. The next time they spoke, Guess said he expected good news, “Instead, he said we are going to suspend shipment of all controlled substances effective immediately with no reason why, no recourse. they won’t even return my calls at this point.”

Guess speculates that a recent $80 million fine against Walgreens has something to do with it. Just five days before McKesson cut him off, the Drug Enforcement Agency slammed Walgreens, the nation’s largest pharmacy chain, for failing to control sales of narcotic painkillers. “McKesson doesn’t want to be the next $80 million fine headline so they decided to shoot first and ask questions later,” Guess said.

Guess also believes they targeted him because most of the prescriptions he fills are pain medications, after all that’s his specialty. However, that also gives him a very high ratio of pain medication prescriptions compared to a regular pharmacy. “I have particularly, the worst of the worst. I have the people with the very high doses” Guess said. That high ratio makes him a target despite his excellent reputation.

Who’s behind it? Some in the pharmaceutical industry believe its the DEA. An estimated 16,000 Americans died from overdoses linked to pain killers in 2010 and the problem is getting worse. No one we spoke with for this story was willing to talk on camera about it, but Tony Park, an attorney and member of the California Pharmacist Association, did talk with NewsChannel 3 by phone. He believes the DEA is using intense political pressure to take the pills off the street. “I suspect the DEA has a national campaign to decrease the total amount of controlled substances in our medicine cabinets,” Park said. He also believes the federal government is using a sledgehammer approach to the problem.

Others in the pharmaceutical industry believe it boils down to simplicity. They say its easier for the DEA to target the large pharmaceutical manufacturers such as McKesson, Cardinal Health and AmerisourceBergen, than to go after every doctor and patient that’s abusing the system.

NewsChannel 3 contacted DEA officials in Los Angeles and Washington. They denied the allegations. “We have no mandates or ratio regulations that would force a supplier such as McKesson to withhold its drugs,” Sarah Pullen with the DEA in L.A. told me by phone. She then referred me to their Washington field office when I asked if the DEA was putting any political pressure on the drug manufacturers. “We don’t involve ourselves in business decisions. We enforce the Controlled Substances Act, that’s it,” said Rusty Payne DEA spokesman in Washington, D.C.

NewsChannel 3 also contacted McKesson for a comment. However, the written response did not address any of our questions. Kristin Hunter, a spokeswoman for McKesson issued the following statement: “McKesson does not fill prescriptions for controlled substances but is one of hundreds of pharmaceutical distributors nationwide. As a pharmaceutical distributor, McKesson complies with laws concerning the monitoring and distribution of controlled substances to customers.”

KEYT NewsChannel 3 also contacted Cardinal Health and AmerisourceBergen for comment, but our calls were not returned.

Meanwhile, Scott Guess says the phone at his pharmacy has been ringing off the hook as frightened patients hear for the first time that they may not be able to get their prescription filled. “We’re hearing about all the prescription overdose deaths, it’s been all over the news, it’s been on headlines everywhere. The other side of that story, is that it’s a small group of people. Eight-million Americans are successfully treated with opiate-based medications for their pain. I serve part of that eight-million people. Well, I did up until a week ago. To reduce the number of accidental overdose deaths, they’re willing to prevent legitimate patients from getting their medication and being treated properly,” Guess said. His 900 patients in the Santa Maria area, like James Birdsall, have no where to go and he expects to be out of business by the end of July.

Melissa Biliardi says every pharmacy she called from Ventura County to Paso Robles has refused to fill their prescriptions. Within days of running out of his medications, James was placed in hospice care, “I’m afraid that I’m gonna run out of time before the battle is won.”

Until then, his mother says she will continue to fight against an enemy that she says has no face. “We will be unstoppable. this is a momma bears promise to her two sons, their children and each of you,” said Biliardi as she spoke to her listeners and tears streamed down her face.

For more information on Huntington’s Disease visit WeHaveAFace.org

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