Opioids data shines light on pain pills usage in Adams County

Over 3.5 million prescription pain pills were supplied in Adams County from 2006 to 2012, according to a recently released nationwide database from The Washington Post.

The Post acquired the data from the Drug Enforcement Administration as the result of a court order. The database, which can be accessed and downloaded at wapo.st/dea-pain-pill-database, contains raw data on shipments of oxycodone and hydrocodone pills to chain pharmacies, retail pharmacies and practitioners.

In the seven-year span from 2006 through 2012, 3,540,050 oxycodone and hydrocodone pills were supplied to Adams County, enough for 28 pills per person per year in the county. Over 56% (1,988,150) of the pills sold to pharmacies were sold to the Othello Pharmacy, while 683,300 pills were sold to the Ritzville Drug Company.

Using 2010 Census data that pegged Ritzville's population at 1,673 people, a rough estimate shows that about 58 pills per person in Ritzville per year were supplied to the Ritzville Drug Company.

All told, Adams County is in the bottom five of the 39 counties in Washington state in terms of pills supplied per person. Klickitat County had the fewest pills per person at 18, while Clallam, Pend Oreille and Asotin County each had at least 70 pills supplied per person in their counties.

About 56% (1,975,650) of the pills that were supplied in Adams County were distributed by Cardinal Health, a multinational health care services company based out of Dublin, Ohio. Most of the rest of the pills in the county were supplied by either Wal-Mart (820,300 pills) and McKesson Corporation (726,900 pills).

Cardinal has a well-documented recent history of discipline and fines from the DEA. According to a Washington Post story in 2008, Cardinal paid a $34 million fine after DEA investigators alleged that the company was sending "millions of doses of painkillers to online and retail pharmacies without alerting investigators to an obvious sign of illegal diversion."

In 2011, investigators alleged that Cardinal had been overlooking escalating oxycodone orders from pharmacies in Florida, including two CVS pharmacies that were eventually shut down by DEA investigators. Suspension orders were filed against Cardinal, and DEA officials said in court documents that Cardinal's activities resulted in "an imminent danger to the public health or safety."

Over 2.1 million (59.4%) of the prescription pain pills supplied in Adams County were manufactured by SpecGx LLC, a subsidiary of Mallinckrodt, an Irish-tax registered manufacturer of specialty pharmaceuticals, generic drugs and imaging agents whose operational headquarters are located in St. Louis, Missouri. In 2017, about 90% of Mallinckrodt's sales came from the U.S. healthcare system.

In all, about 1.85 billion prescription pain pills were supplied to Washington state. More than half of the pills supplied to the state were manufactured by SpecGx, and more than half were distributed by Cardinal and McKesson.

Nationwide, a staggering 76 billion oxycodone and hydrocodone pills were shipped across the country from 2006 to 2012. Some 12.6 billion pills were supplied in 2012, a 50% increase from the 8.4 billion pills that were supplied in 2006. For comparison, The Washington Post said that 500 million doses of morphine-another common treatment for severe pain-were supplied per year.

The U.S. opioid epidemic can be traced to the late 1990s, according to the U.S. Department of Health and Human Services. During that time, pharmaceutical companies reassured the healthcare and medical community that patients would not become addicted to opioid pain relievers. In turn, healthcare providers began to prescribe them at greater rates.

The increased prescription of opioid medications, HHS says, led to widespread misuse of both prescription and non-prescription opioids before it was realized that the painkillers actually could be highly addictive. According to the Washington State Department of Health, there were 355 opioid-related deaths in Washington state in 1999. In 2017, there were 739 deaths, more than double the amount of opioid-related deaths in a span of less than 20 years.

In 2016, opioid overdoses accounted for more than 42,000 deaths in the United States, more than any previous year or record. In 2017, HHS declared a public health emergency.

HHS estimates that more than 130 people died every day from opioid-related drug overdoses in 2017 and 2018, and that 11.4 million people misused prescription opioids. An estimated two million of those people misused prescription opioids for the first time.