EBM meets capitalism — prescription for carnage

This is from a book review in the FT of American Overdose. by Chris McGreal — prescription for carnage.

McGreal has written an interview-based book, with especially vivid reporting from West Virginia, the state hit hardest by the epidemic. In the little town of Williamson, or Pilliamson as people came to call it, pharmacies were dispensing opioids at a staggering rate both to locals and to out-of-state visitors, who clogged its streets with their cars but boosted some local businesses as well as city tax revenues.

When the federal authorities belatedly raided one Williamson clinic in late 2009, they found that an individual doctor had written 355,132 opioid prescriptions over the previous seven years — about 1,000 for every inhabitant of the town. Another wrote 118,443 scrips over the same period. Most were handed out for cash fees without the doctors bothering to see their patients. The investigators estimated that the clinic took in $4.6m cash during 2009 and they found banknotes stuffed into safes and cupboards in the doctors’ homes and offices.