Valley Forge, Pennsylvania, 2011
The parody was of the theme song from the 1960s CBS sitcom The Beverly Hillbillies:
“Come and listen to a story about a man named Jed,” it began. “A poor mountaineer, barely kept his habit fed, / Then one day he was lookin at some tube, / And saw that Florida had a lax attitude. / About pills that is, Hillbilly Heroin, ‘OC’ [oxycodone].
“Well the first thing you know ol’ Jed’s a drivin South,” the parody continued. “Kinfolk said Jed don’t put too many in your mouth, / Said Sunny Florida is the place you ought to be / So they loaded up the truck and drove speedily. / South, that is. / Pain Clinics, cash ’n carry. / A Bevy of Pillbillies!”
At the height of the opioid epidemic, executives at AmerisourceBergen sent around an email with this takeoff of a show that reinforced the worst stereotypes of people from places like Appalachia—slow-talking, dirt poor, and uneducated. “Saw this and had to share it,” wrote Joseph Tomkiewicz, an AmerisourceBergen corporate investigator, in an April 22, 2011, email.
Two of Tomkiewicz’s colleagues then forwarded it to others, including Julie Eddy, director of state government affairs for AmerisourceBergen. She wrote back to one of them, Chris Zimmerman, the vice president of regulatory affairs for the company: “I sent this to you a month or so ago—nice to see it recirculated.” She closed her email with a smiley face emoji.
In 2011, nearly sixteen thousand people died from prescription opioid overdoses. Appalachia, including West Virginia, Tennessee, Kentucky, Ohio, and southwestern Virginia, had become the epicenter of the nation’s opioid crisis. That year alone, AmerisourceBergen distributed 1.7 billion pain pills in the United States. In April, as AmerisourceBergen employees were getting a laugh out of the “Pillbillies” parody, the company shipped 291,400 pills of hydrocodone and oxycodone to just one county in West Virginia—Cabell County, population 96,612—in the heart of Appalachia.
One of the world’s largest pharmaceutical service companies, AmerisourceBergen ranked twenty-seventh on the Fortune 500 list with $77 billion in annual revenue. It was headed by South African native Steven H. Collis, who joined the company in 2011. His annual compensation package was worth $4.6 million.
AmerisourceBergen was one of the companies that had received a letter from Joe Rannazzisi outlining its responsibility to stop and report outlandish drug orders. In 2007, when Joe and his DEA team had been investigating illegal opioids sales over the internet, they raided and shut down the company’s Orlando distribution center and temporarily suspended its license, alleging that AmerisourceBergen had distributed 3.8 million doses of hydrocodone products in one year to rogue online pharmacies.
The same year the company executives circulated the “Pillbillies” parody, AmerisourceBergen and other drug companies were trying to block legislation being debated by the Florida Legislature to curb the explosion of the pill mills and subject drug distribution companies to strict reporting requirements for all shipments of pain pills to the state. After several media investigations into the pill mills, the state legislature was forced by growing public concern to consider a law that would police the industry and stop the drugs being moved along the Blue Highway and on the Oxy Express.
The legislation required companies to submit monthly drug distribution reports of controlled substances to the Florida Department of Health. Improper distribution and false reporting would now be felonies. The law also barred most doctors from dispensing narcotics from their offices or clinics and allocated $3 million to law enforcement to investigate and target pill mills suspected of violations. To prevent doctor shopping, a state prescription monitoring system would identify how often a person was prescribed pain pills, which doctors prescribed them, and which pharmacies dispensed them.
In a series of private emails, executives for McKesson, Cardinal Health, and AmerisourceBergen mapped out a lobbying strategy to defeat or amend the legislation. On April 21, 2011, Ann Berkey, a senior vice president in charge of public affairs for McKesson, wrote an email to the top lobbyists for Cardinal Health and AmerisourceBergen. The subject line: “Florida Pill Mill.”
“We are very concerned about the pending state pill mill bill and could really use your help on the ground in Tallahassee next week,” Berkey wrote. She said that three McKesson executives and a lobbyist were working the state House of Representatives, but they needed help with the Senate. “Looks like outright defeat is no longer a viable option. Any way you can persuade some of your execs to come to Tallahassee next week? We are much stronger as a group!”
The lobbyist for AmerisourceBergen, Rita Norton, wrote back on April 25, noting that Julie Eddy—the same executive who added the smiley face emoji to the “Pillbillies” email—was flying to Florida to help with the lobbying effort to defeat the bill.
The push to kill the legislation, however, failed; it passed the following month. Lawmakers could not ignore the spotlight that had been put on their state by the DEA and journalists. Republican Florida governor Rick Scott signed the pill mill legislation in June 2011. There was an element of karma to the governor’s signature. He had been personally singled out in the “Pillbillies” parody.
“Well now it’s time to say Howdy to Jed and all his kin,” read the last stanza. “And they would like to thank Rick Scott fer kindly invitin them. / They’re all invited back to this locality / To have a heapin helpin of Florida hospitality / Pill Mills that is. Buy some pills. Take a load home. Y’all come back now, y’hear?”