The Kern River Valley has one of the most severe opioid problems in California. One particularly stricken burg in the area, Wofford Heights, has an opioid overdose rate five times the national average.

So, when a previously unreleased database maintained by the Drug Enforcement Administration showed that a busy rural pharmacy, The Drugstore in Kernville, has been buying and dispensing oxycodone and hydrocodone pills, two of the most abused and deadly opioids on the market, at what seemed an astounding rate, a phone call was in order.

Between 2006 and 2012, drug manufacturers shipped more than 6 million oxycodone and hydrocodone pills to the bustling little mountain pharmacy on Piute Drive — enough for 870 pills per year for each of the 995 people who live within 5 miles of its front door.

That confluence of data points prompted an obvious question: What, if anything, might connect the two?

The Washington Post obtained the DEA's national data on licensed pharmacies by court order on July 15, broke it down and on Sunday dropped some numbers. Among its findings: Over that seven-year period, 15 percent of U.S. pharmacies, about 1,000 of them, received 48 percent of pain pills, or about 100 million pills.

Some of the highest-volume dispensers of those two opioids are based in the same regions of the U.S. where opioid addiction and overdose are among the worst: West Virginia, Kentucky and southwestern Virginia.

The Kern River Valley is in their dismal company, led by Wofford Heights, which had 22.8 opioid overdoes per 100,000 residents in 2017, nearly five times the national figure.

Hold it right there, says Austin Horn, The Drugstore's pharmacist. His pharmacy, he maintains, is being stigmatized by the study's misleading parameters.

Pill-to-person ratios that establish a 5-mile radius as their basis — as the Post study does — might have some value in high-density areas where competition affords customers more choices, but The Drugstore fills prescriptions for customers for 50 miles around and has one solitary competitor 12 miles away, in another nearby town.

"We're a high-volume pharmacy," Horn said. "We service the whole area."

But not high volume for opioids — at least not based on percentage of all drugs dispensed, according to Horn. Just 18 percent of prescriptions filled by The Drugstore are controlled substances, he said.

"That puts us on the low end of the scale," Horn said. "So this study is a little bit skewed. It's very misleading."

He wouldn't speculate on the root of the Kern River Valley's opioid problem.

"I don't know," he said. "I'm not the one who chooses what to prescribe to people."

Neither can he track what happens to prescribed painkillers once they leave his store. 

That's a trail worth following, though, and several states are doing so with billboard campaigns that warn parents about leaving their pain medication in accessible places such as bathroom medicine cabinets.

As a pharmacist, Horn knows this: State and federal regulatory agencies are looking over his shoulder with unprecedented scrutiny. 

"They're all retired DEA agents, and they know their customers — us, the pharmacies — just like we know our customers," the patients, he said.

Another factor in the Kern River Valley's opioid overdose epidemic is its lack of a state-licensed narcotics treatment programs. As The Californian reported in 2017, none of the state's 21 ZIP codes with the highest overdose rates has such a program. Few had opioid treatment programs within 40 miles.

California is in the process of rolling out a program, modeled after one developed in Vermont, that allows physicians to dispense buprenorphine, an addiction-fighting narcotic, through rural clinics or physicians' offices working in collaboration with nearby opioid treatment programs. 

Lake Isabella currently has none of those treatment options.

The opioid addiction crisis has several points of entry: Among them, pharmaceutical companies, treatment protocols, prescribing physicians, dispensing pharmacies, uncautious parents, the black market, and uneven treatment opportunities.

Kernville's pharmacist embraces regulatory scrutiny, but his message today is this: Nothing to see here.

Horn's initial reluctance to talk about the pharmacy business didn't stem so much from The Post's exploration of the DEA's data, he said, as this:

"We're a family business, and we're one of the only drugstores around; business is good," he said. "We don't need CVS knowing it's a great place to do business. They're ruthless."

Contact The Californian’s Robert Price at 661-395-7399, rprice@bakersfield.com or on Twitter: @stubblebuzz. His column appears on Sundays, Wednesdays and Saturdays; the views expressed are his own.

(5) comments

Maryg47

Mr.Knowitall, you can't even get the facts straight from the article. The Drug Store is about 17miles from Lake Isabella where Rite Aid is and about 12 miles from Mountain Mesa where the other pharmacy is. But the do serve a large population including me. I've been going the since 03. It's a very friendly and efficient Pharmacy. They have excellent customer relations. They treat everyone with dignity and professionalism. I myself had to sign an agreement with my Primary Physician to get Hydrocodone for my back pain. I get 7.5mg and only when my back is really hurting from overworking it, Scoliosis, I take only 1/2 a pill which amounts to 3.75mg a day. I can't even take 1/2 a pill 2 days in a row because it makes me nauseous. I never sell my pills or even let anyone know I have them. There are those that abuse them or sell them. It makes people like me that need them look bad. The pharmacy also has strict rules and guidelines they follow. If I had to speculate, I'd say a good 80% or higher of their patients they have are senior citizens that have severe pain which comes with age. It's those few people that get opioids because they can and sell them or misuse them that's the problem. So find those people but don't blame the Pharmacy for doing its job!!!

Mrknowitall

Quit squinting when using calculator Mr. Editor.

The numbers say that the drug lord pharmacy dude is giving out heavy opiates. A million pills per year. At two pills a day for 352 days that means he’s gotta have 2,000 different customers. He tries to cloud the issue with “the nearest competition is 50 miles away” hoping that we think he provides everyone within a 50 mile radius. NO. The other pharmacies on the outskirts also selling into that 50 mile radius, so really his sweet spot would be capturing the majority within a 25 mile radius. Within that 25 mile radius he wants us to believe that those tiny hamlets surrounding him consist of 2,000 opioid zombies... Er, patients. In other words, since there’s only 900 population in his town, and similar populations in the few others in that neck of the wood—- that would mean that just about every household in those populations are drug zombies OverDosing on the regular and quite frequently. Bob Price got the wool pulled over his eyes pure and simple. What kinda country bumpkin journalism is the once mighty Californian settling for these days. The guy selectively edits anyone who calls him out so that the posts are out of context and lack gravitas. His aim to look superior. Dude—when you get journalistically slapped just say thank you, may I please have another. Happy to oblige.

7nickfish

The pharmacist is 100% right. Readers that blame him are so easily led by statistics they fail to realize where this pharmacy is and it has nothing to do with the RX being written by others. Also there are a large number of elderly and disabled so the population is also not normal. TO say "close it down" fails to eve understand the real facts. As Joe Biden said, believe the truth and not the facts

Brainuser

I totally agree with you. You could not have stayed it any better. Thank you. What a disservice to the area it would be to close it down.

PedoHater

Shut this murderous drugstore and stop selling this product

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