Over the course of seven years, from 2006 to 2012, two pharmacies in rural northeast Louisiana, owned by Republican gubernatorial candidate and U.S. Rep. Ralph Abraham, Clinic Pharmacy of Mangham and Adams Clinic Pharmacy of Winnsboro, doled out 1,478,236 doses of powerful opioids, according to a Drug Enforcement Administration database recently published by the Washington Post.

The pharmacies are 12.5 miles away from one another, and the two communities have a combined population of approximately 6,000 people. Despite the surge in opioid prescriptions, the region’s population has actually decreased during the previous twenty years.

Abraham has been openly enthusiastic about his support for opioid treatments, once suggesting that the drugs are far less dangerous and much more effective than medical marijuana. Five years ago, during an October 2014 debate for Congress, Abraham claimed he did not support “the legalization of marijuana on any level.”

“Again, as a physician, let me tell you. What I see in my practice, from any level of marijuana use, is bad,” Abraham stated. “I’m against recreational, I’m against medical. In the medical profession, for these chronic pain, poor cancer patients that need help, we have other alternatives that work better, Dilaudid, OxyContin, you name it, Oxycodone, we have several options that do a much better job for chronic pain.

“I’ve had hundreds of patients unfortunately with cancer that I’ve treated, they do well with these drugs,” he continued.

According to the Centers for Disease Prevention and Control, opioid overdoses surged an astonishing 14% in 2014, which was largely a consequence of physicians overprescribing the drugs. Abraham’s home parish of Richland is one of the least populated in the state, ranking 46th of 64, yet according to the most recent estimate, it ranks as the 8th worst in opioid prescriptions. As of 2017, for every 100 people in Richland, there were an astonishing 113 opioid prescriptions.

“Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of drug overdose deaths,” states the CDC. “Opioids were involved in 47,600 overdose deaths in 2017. A staggering 67.8% of all drug overdose deaths are due to opioids, and while nationwide these numbers have declined, Louisiana is one of a handful of states in which deaths from opioid overdoses have increased.

During the past year, overdose deaths went up by 4.7% in Louisiana.

“Louisiana also ranks among the top 10 states with the most opioid prescriptions written per capita, according to its state’s lawsuit against 17 companies, including Purdue Pharma,” according to a report published yesterday by APG Wisconsin. “Since 2007, the state has spent at least $677 million ‘for treatment of opioid use and dependence.’”

ralph abraham opiods

During the seven-year timeframe, Abraham’s pharmacy in Winnsboro doubled the number of opioids it dispensed to patients; opioid prescriptions filled at his pharmacy in Mangham, which is located near his former medical clinic, surged a staggering 67%.

In Mangham (2017 population: 638), Abraham’s pharmacy supplied enough opioid medication to provide every man, woman, and child 6.1 doses every year (or 43 pills in total) for seven consecutive years; his pharmacy in Winnsboro (2017 population: 4,652) could have provided every resident 4.4 doses per year (or 31 in total). (Note: Annual doses per person were based on Census estimates, not the most recent American Community Survey).

Thus far, the only publicly-available data concerns manufacturers, distributors, and pharmacies filling the medications, but there is significant pressure for the government to also identify the physicians responsible for writing a substantial number of opioid prescriptions, particularly those who, like Abraham, also maintain ownership interests in nearby pharmacies.

It Pays to Prescribe

Source: Louisiana Secretary of State.

According to documents filed with the Louisiana Secretary of State, Abraham founded the Clinic Pharmacy of Mangham in 2003 and co-founded the Adams Clinic Pharmacy of Winnsboro three years later. In 2008, when he and his wife sought court approval for their “matrimonial regime of separate property,” Abraham submitted as “Exhibit A” an inventory of his property and ownership interests.

At the time, he owned 24.5% separate share in the Adams Clinic and a 25.5% separate share in the Clinic Pharmacy of Mangham; the remaining shares were presumably community property with his wife and family or, in the case of the pharmacy in Winnsboro, the separate property of his business partner, Kayla Bridges, a former employee of Abraham’s medical practice who received her pharmacist’s license in 2006.

Source: Fifth Judicial District Court, Louisiana, Docket No. 40214-B, Exhibit “A” Ralph L. Abraham Jr. Separate Property Assets and Liabilities, 1/23/08

Notably, A&B of Richland Parish and B&A of North Louisiana are apparently both partnerships between Abraham and Bridges, though Abraham’s name was removed from A&B in 2013 and B&A in 2015, after his election to Congress. Despite the fact that Abraham claims to have sold his ownership interest in the pharmacy in Winnsboro to Bridges in 2015 and his ownership of his Mangham pharmacy to her just last year, according to his most recent personal financial disclosure report, Bridges still owed him between $15,001-$50,000 for his shares of A&B and between $250,001 to $500,000 for the Clinic Pharmacy of Mangham.

Last year, even though he “sold” his pharmacy in Mangham, he still earned between $50,000 – $100,000 in income from the business, as he has every year since his election except, for reasons unexplained, in 2014.

If this seems convoluted, that was the point.

But regardless of the accounting gimmicks or the attempt to cleverly deflect attention from the sources of his income, the simple truth is that Ralph Abraham has made a fortune through his ownership of two rural pharmacies that sold a disproportionate and astonishing amount of dangerous opioids. Indeed, it appears Abraham continues to make a fortune from his pharmacy in Mangham.

The Clinic Pharmacy of Mangham, Louisiana. Photo Credit: Sue Lincoln

Oh but the pusher is a monster
Good God, he’s not a natural man

Aside from the staggering volume of opioids that Abraham’s two rural pharmacies dispensed from 2006 to 2012, there is one other detail that is impossible to ignore: With only one insignificant exception, he ordered all of his supply, nearly 1.5 million doses, from a single distributor, the Shreveport-based, family-owned company Morris & Dickson.

Morris & Dickson is the second-largest opioid distributor in the state of Louisiana, or at least it once was.

On May 2nd, 2018, the DEA suspended the company from distributing controlled substances, after a months-long investigation revealed it had been supplying pharmacies with massive shipments of opioids, in direct violation of the law.

A small portion of orders sent to Abraham’s two pharmacies. Source: DEA.

“In October 2017, DEA became aware of the high-volume sales of Oxycodone and Hydrocodone from Morris and Dickson Company to five of the top ten purchasing pharmacies within the state of Louisiana,” the federal agency announced in a press release. “DEA records indicated that Morris and Dickson Company had not filed any suspicious order reports on any of the pharmacies in question in Louisiana.”

It was the first time the DEA had issued a such a suspension since 2012. “Not only were numerous ‘independent’ retail pharmacies purchasing more Oxycodone and Hydrocodone than the largest chain pharmacies operating within the state, they were purchasing more narcotics than several of the largest chain pharmacies combined within the same zip code,” the DEA explained. “In some instances, DEA noted these ‘independent’ pharmacies were purchasing more than ten times the amount of narcotics the average Louisiana pharmacy purchased per month.”

Yet only sixteen days after it issued the suspension, the DEA withdrew it, according to an announcement made on the company’s Facebook page.

Only months prior, the company’s president, Paul Dickson, was Ralph Abraham’s guest at the State of the Union.

Dickson, a prolific donor to Republican politicians and PACs, has already contributed the maximum to Abraham’s gubernatorial campaign; so has Dickson’s wife. Dickson was recently named as a member of Abraham’s campaign finance committee.

In May of this year, his company agreed to pay $22 million in civil penalties to settle charges it had violated the Controlled Substances Act. “In addition to paying $22 million in settlement funds, Morris & Dickson also agreed during the course of the negotiations to make significant upgrades to its compliance program by investing millions of dollars to hire additional staff and implement new protocols and standards to ensure compliance with federal regulations requiring them to report suspicious orders of controlled substances,” the Shreveport Times reported.

You know, I’ve seen a lot of people walkin’ ’round
With tombstones in their eyes
But the pusher don’t care
Ah, if you live or if you die

Seven months ago, a person from northeast Louisiana posted a troubling and potentially explosive allegation as a comment on Facebook in response to one of the Bayou Brief’s previous reports on U.S. Rep. Ralph Abraham. According to the individual, whose identity we have confirmed but are withholding out of concerns for personal and professional retaliation, the physician-turned-congressman had been known as a leading prescriber of powerful opioids, some of the most addictive and deadliest medications on the market.

The comment remained online for over 48 hours before the person, perhaps wisely, decided to delete it. I had reached out privately, both to express my appreciation for their courage and to caution them about the potential backlash they could receive.

The person, who lived in the vicinity of both pharmacies, claimed direct knowledge of the doctor’s preferred way to treat and manage patients suffering from pain, which Abraham has already essentially confirmed. They also offered to contact two others who were forced to seek treatment after becoming addicted to opioids they had allegedly received either from Dr. Abraham or through one of the two rural pharmacies he owned in the area.

However, speaking publicly about an addiction, particularly in the context of a political campaign, is incredibly challenging, and understandably, after thoroughly considering the potential public scrutiny, they decided to refrain from conducting an on-the-record interview. Still, for anyone who has read the Washington Post’s reporting or reviewed the DEA’s database, the details of this person’s experience should not be surprising; millions of Americans have had similar experiences and struggles.

One would think, at the very least, that Abraham would support the bipartisan effort to hold these pharmaceutical companies for misrepresenting a potentially and highly addictive lethal drug, creating what can fairly be characterized as an epidemic and a crisis, and pocketing billions of dollars in profit as a direct result.

Yet Ralph Abraham has repeatedly expressed his opposition to lawsuits filed against opioid distributors and manufacturers, arguing that these pharmaceutical companies are merely meeting the market’s demand.

In 2017, during an interview on Talk 1073, the congressman was directly asked his opinion on the lawsuits, and he twice claimed not to know of any “objective data” linking the misleading practices of opioid manufacturers with the proliferation of prescriptions and fatal overdoses.

“I wanna get some objective data first, and I don’t want it to be you know, like some of these large class-action suits that we have had in the past, where they just throw the baby out with the bathwater,” he said, presumably referring to either the class action suits against tobacco companies or against BP in the aftermath of the Deepwater Horizon disaster. “So you know, let’s see where the problem lies. You’re correct, the manufacturers are simply meeting a demand that is being, maybe, abused by some physicians. Certainly abused, illicitly, by some street dealers.” 

Earlier in the same interview, Abraham acknowledged being fearful of having the Drug Enforcement Agency monitoring physicians who write “long-term” prescriptions for opioids.

He was not referring to himself when he spoke about the drugs “being, maybe, abused by some physicians,” and he has never disclosed how many of the opioid prescriptions he wrote for patients were filled at one of his pharmacies.

In fact, he has continually claimed that he gave up the practice of medicine in order to serve in Congress, though his own financial disclosure reports seem to directly contradict that assertion.

There is at least one prominent Republican in Louisiana who adamantly agrees with the lawsuits against opioid manufacturers, distributors, and prescribers: state Attorney General Jeff Landry. He calls it “one of the (state’s) most challenging and complex problems,” estimating that the opioid epidemic is already costing Louisiana more than $160 million every year.

More importantly though, it’s costing Louisiana more than 1,000 lives annually and thousands more to seek treatment for drug dependency. Incidentally, drug and alcohol addiction facilities have also poured big money into Abraham’s campaign. They apparently believe he’s good for their business, and it’s difficult to argue otherwise.

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Lamar White, Jr.
Lamar writes about the people, the politics, and the magic of Louisiana. He is the founder and publisher of the Bayou Brief and a contributing writer for the Daily Beast. Lamar is best known for his investigative reporting on public corruption, racism, and civil rights. He has appeared as a guest on CNN, MSNBC, and the BBC, and he's been the subject of profiles in The Washington Post, The Advocate, and Huffington Post. Before launching the Bayou Brief, he published CenLamar, a popular blog that initially covered the drama of City Hall in his hometown of Alexandria. Lamar is a graduate of Rice University in Houston and the Dedman School of Law at Southern Methodist University in Dallas. Today he lives in New Orleans and is currently writing a book about the life of reputed New Orleans Mafia boss Carlos Marcello. Support Lamar's work on Patreon.