State Senator Shane Reeves of Murfreesboro says he wasn’t surprised to see his pharmacy as the top recipient of opioids in Tennessee — more than double the next highest pharmacy in the state according to a Washington Post database.
Over a six year period, more than 45 million pain pills passed through what is now named Twelve Stone Health Partners. But Reeves also rejects that his business contributed to the opioid epidemic.
Asked to explain how the company became such an outlier on opioids, Reeves insists on giving a tour of the company's new facility.
A scanner double-checks pre-packaged medication that leaves this facility, which is a renovated strip mall in Murfreesboro. Pharmacist Leanne Kelley stares at a monitor showing potential errors caught by the system. The pre-packaged medication is prepared for patients to take morning, noon and night — even partial pills.
"It detected that little bitty piece of crumb from that half tablet right there," she says, pointing to a speck in the sealed pouch.
Reeves highlights the quality control measure as evidence of both how his pharmacy has grown and how concerned the company is with patient safety and keeping the drugs out of the wrong hands.
When Reeves' father started the business in 1980, it was a retail pharmacy. But that side of the business was sold off to Fred's in 2015, and the remaining service lines have become Twelve Stone Health Partners, which is licensed in 47 states. The firm employs 130 people and caters exclusively to complex patients, mostly in nursing homes and assisted living.
"These are people taking 10, 15, 20 medications a day," Reeves says.
Twelve Stone also specializes in compounding drugs and intravenous infusions, shipping them to patients and administering them at its spa-like storefront.
But the bulk of the opioid count from 2006 to 2012 came from the firm's big contracts with hospice agencies, Reeves says. Locally, for example, the pharmacy has maintained an exclusive deal with Alive Hospice.
"We do all of it," he says, referencing the hefty narcotic doses to thousands of patients a year. Every hospice patient starts with a bottle of morphine on hand. Most require much more.
"You’ve got an individual, at home, who’s got cancer, who’s at end of life, and we’re dispensing pain medication to them," he says. "And if there’s diversion in those homes, at that point in time, it’s a bigger issue within that family."
There are widespread reports of family members or caregivers stealing medication from hospice patients. But Reeves says it’s virtually impossible to game the system on his end.
"I do not believe that the addiction problems and the overdose problems and the diversion problems in the state of Tennessee are being caused because of hospice patients," he says.
A review of Twelve Stone’s licensing documents show the company has never been in trouble with state regulators. And Reeves says the only visits he’s ever had from federal drug enforcement have been standard audits. The DEA declined to comment.
While he’s not concerned about the sheer volume of opioids passing through his pharmacy, he says it's likely much lower now given how insurance plans and state laws have restricted dosages in recent years.