Pete Crouch

In this Sept. 13 portrait, Pete Crouch looks over a prescription while a box of Narcan sits in the foreground at his drugstore in Eden. Crouch said he tries to persuade all of his opioid customers to get Narcan along with their prescription, just in case.

EDEN — Pete Crouch’s drug store and pharmacy on Stadium Drive dispensed 4.5 million pills during a span of seven years, fourth most among Triad retailers.

His Eden Drug Co. is a relatively compact, one-store operation in a county with high per-capita usage of prescription painkillers.

He must be up to no good, right?

Crouch said nothing could be further from the truth. He and his staff make great efforts to ensure that all opioid prescriptions they dispense are legitimate and that customers who receive them understand they’re getting a potentially addictive substance, Crouch said.

“When opiates kill more people than car accidents, that’s a huge problem,” said Crouch, who has owned and operated Eden Drug for 13 years.

“We are extremely dedicated to protecting their safety,” he said. “Somebody who goes to the dentist and gets a hydrocodone prescription for 10 pills, that’s one thing.”

“But it’s a different matter for someone who has had hip replacement surgery and is now taking high doses of opiates on a regular basis.”

Data from the Drug Enforcement Administration released recently in the nationwide “multidistrict litigation” underway in Ohio raised eyebrows by reporting the dispensation of opioid pills from the manufacturer and wholesaler down to individual pharmacies nationwide.

Some assumed that just as extremely high production numbers among corporate pill makers had raised red flags enough to fuel lawsuits, the same was true for individual pharmacies at the local level.

Not true, said Jay Campbell, executive director of the North Carolina Board of Pharmacy that supervises drug dispensaries and their professional staffs statewide.

“It’s useful data, but it’s not a magic bullet,” Campbell said of the DEA files. “It’s a blunt tool.”

“A big number might be indicative of a problem or it might not be indicative of anything at all.”

To determine that a retail pharmacy or some of its staff members have been dispensing opioids improperly for their own use or illicit sale takes “good, old-fashioned gumshoe investigative work,” Campbell said.

A particular pharmacy might have high opioid numbers simply because its client base includes many nursing home or hospice residents likely to use more powerful painkillers, he said.

In Crouch’s case, he does work with hospice patients. But he said he also built his business to the point where Eden Drug rings up about $12 million per year in sales, three to four times the average for a community drug store.

Filling more than 600 prescriptions per day, the operation includes robotic equipment that can sort and package each patient’s order.

For patients who take multiple combinations of pills every day, the computerized system can spit out a 30-day roll of packets, each time stamped for the day and hour the patient should take its contents.

Looked at as a percentage of Eden Drug’s overall business model, “we are way down on the list” of area pharmacies for dispensing opioids, Crouch said.

As a precaution against overdoses, Crouch said that he and his staff do an overdose risk assessment for each of their customers taking prescription opioids.

For instance, someone with COPD or another respiratory ailment would be at higher risk for complications because opioids can hinder lung function, he said.

Knowing of opioids’ problem-causing potential, Crouch said, pharmacists at Eden Drug encourage customers who are taking them to also buy a special, naloxone preparation that can reverse an overdose.

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