The deadliest drug epidemic in US history did not involve peddlers, gangsters or smugglers, but painkillers. Between 2006 and 2014, a single county in West Virginia was supplied with over 127 million prescription opioid pills—142 pills a year for every person—that fed an opioid-addiction crisis that is still playing out. On Monday, a federal judge dismissed charges against America’s three biggest drug distributors levelled by Cabell County and Huntington City, ground zero of the epidemic in that state, for ignoring truly alarming volumes of opioid sales in towns with very few people. The judge acknowledged the enormity of the harm done to locals, but ruled that these channels funnelling legal pills made by drugmakers to pharmacies and hospitals could not be held accountable for leakages that led to wide misuse and overdose deaths. No law was found to have been violated in this case. The legal victory of pill funnels, however, must not distract us from the pharma-medical complex responsible for a glaring problem.