The Drug Enforcement Administration recently released a database they have maintained to track every pain pill sold in the United States.
From manufacturers through distributors to the pharmacy where it gets into the waiting hands of patients, this database shows the way these pills were distributed, and the sheer numbers in which they flooded into the country.
The Washington Post then sifted through nearly 380 Million transactions from 2006 through 2012, and put them into a clever little database on their website so readers could get a clearer look at their particular communities, and other news organizations could more-easily disseminate the information for their own readers — because, you know, the Coastal Point just ain’t getting through 380 million transactions with our staff.
I mean, you should see us try to order pizzas for a staff meeting. Great googly moogly, you would think...
But I digress.
Before we really dive into this, let me genuinely thank the Washington Post for sharing this information. The Post and HD Media (publisher of the Charleston Gazette Mail in West Virginia) locked horns with the DEA and drug industry for a year, trying to get access to this information (as have many of us smaller newspapers who simply didn’t have the resources to fight). Finally, as the result of a court order, the Post gained access to the Automation of Reports and Consolidated Orders System, known as ARCOS.
The Post then made it available for all of us to share with our readers, so, from the bottom of our hearts... Thank you.
This seven-year period, from 2006 through 2012, saw nearly 100,000 people die in this nation from opioids, and more than 76 billion oxycodone and hydrocodone pills were distributed. The Post’s analysis shows that the volume of pills increased from 8.4 billion in 2006, to 12.6 billion in 2012. Six companies distributed 75 percent of the oxycodone and hydrocodone pills during this timeframe, led by McKesson Corp., a pharmaceutical wholesaler that distributed 14 billion pills, or 18.4 percent of the entire market. They were followed by Walgreen’s, Cardinal Health, AmerisourceBergen, CVS and Walmart.
“Three companies manufactured about 88 percent of the opioids; SpecGX, a subidiary of Mallinckrodt; Actavis Pharma; and Par Pharmaceutical, a subisidiary of Endo Pharmaceuticals,” explained the Post.
Locally, the numbers were staggering. From 2006 through 2012, there were 82,872,450 prescription pain pills distributed in Sussex County.
Let that roll around in your brain a little bit. In seven years, there were nearly 83 million prescription pain pills legally distributed in Sussex County. The Post estimated that total being enough for 62 pills per person, per year. Walgreens distributed more than 33 million pills in that period, nearly 8 million more than McKesson did in that time period in Sussex. Sussex County Walmarts distributed almost 8 million pills.The Pill Box Pharmacy in Milford was the single top-distributing location in the county over those years, distributing more than 7 million pills.
This is significant. I’ve spent many hours talking with local police officers regarding the opiod problem in our community, from the earliest days of the prescription pill problem through the heroin infiltration we still very much see today. They overwhelmingly believe our current heroin and fentanyl struggles are due to people becoming addicted to opioids during this prescription pill onslaught.
In 2011, we ran a three-part series on the prescription pill crisis in our community. Selbyville Police Chief Scott Collins offered to us at that time a narrative he had seen too many times in his experience.
“A lot of abusers started out by being legitimately hurt and required a prescription,” said Collins. “They needed the pills just to manage the pain. But then they get addicted. They can not get off the pills. You see people who you wouldn’t expect to have drug problems become addicted and have very real drug problems. At that point, they do whatever they can to get hold of the pills.”
Then-Frankford Police Chief William Dudley discussed another element to addiction that compounded these problems even more.
“... But, oftentimes, they become addicted, and they feel there’s a stigma to having a drug problem,” he said. “At that point, it’s hard for them to come out and ask for help, and the problem gets worse.”
A good friend of mine went through this very situation. He endured numerous back surgeries and apparently developed an addiction to his prescription pain pills — an addiction I, and other friends in our circle, had no idea he was suffering. He overdosed, died and left behind two kids. He would be a grandfather today, but never had that opportunity. I’ve cried several times over that joy he never got the chance to experience, and still do today when I see their pictures pop up on my social media feeds.
There was a brother of another dear friend, also introduced to opioids after years of surgeries and medical procedures, who eventually lost his life thanks to those demons. A huge smile and friendly way about him is how I remember him now, tinged with sadness over what could have been for him in the future.
There was also a woman who sat in my office and shared a story about her son, who had developed an opioid problem while away at college, originally through legitimate prescriptions.
“There’s a pretense of trust,” she explained. “You’re supposed to trust that doctors are looking out for you. But he can just go into any doctor’s office and come away with a prescription that can ruin his life? I don’t have that level of trust in doctors anymore.”
Can you blame her?
It’s not just doctors writing too many prescriptions that caused this. That’s way too easy, and doesn’t cast nearly a wide-enough net. No, the Post’s reporting shined a light on the disgusting underbelly of unbridled greed and rampant don’t-give-a-[fill in the blank] that contributed to one of the most terrifying and repugnant blights in the history of this nation.
A landmark lawsuit is being played out in Cleveland right now as nearly 2,000 lawsuits filed by various cities, counties and Native American tribes against the pharmaceutical industry are being bundled into one case, per an article in the Wall Street Journal.
“With their motion, plaintiffs lawyers are asking U.S. District Judge Dan Polster to find the defendants failed to comply with requirements under the federal Controlled Substances Act to report and halt suspicious drug orders,” according to the article. “Such a finding, the plaintiffs say, would help streamline the October trial and bolster their other claims.”
In a July 19 Washington Post piece, a 2008 email is shared between a representative of Mallinckrodt and a client at a wholesale distributor. Victor Borelli, national account manager at Mallinckrodt, told Steve Cochrane, VP of sales for KeySource Medical to check his inventories. “[i]f you are low, order more. If you are okay, order a little more, Capesce?”
Borelli then joked, “destroy this email... Is that really possible? Oh Well...”
In another email, sent in January 2009, Borelli told Cochrane that 1,200 bottles of oxycodone 30 mg tablets had been shipped.
“Keep ’em comin’!” Cochrane responded. “Flyin out of there. It’s like people are addicted to these things or something. Oh, wait, people are...”
Borellie replied: “Just like Doritos ... keep eating. We’ll make more.”
Confronted by the emails, Mallinckrodt issued a statement on Friday, July 19: “This is an outrageously callous email from an individual who has not been employed by the company for many years. It is antithetical to everything that Mallinckrodt stands for and has done to combat opioid abuse and misuse.”
Cardinal Health, one of the nation’s largest drug distributors, had been hit with nearly $1 billion in “fines, settlements, and lost business as a result of multiple regulatory actions,” in the 18 months preceding January 2008, according to court filings, per the Washington Post. That January, then-CEO Kerry Clark sent an email to Cardinal senior officials that the company’s “results-oriented culture” was perhaps “leading to ill-advised or shortsighted decisions.”
The National Institues of Health’s (NIH) National Institute on Drug Abuse released a revised report in January 2019 titled “Opioid Overdose Crisis.” They described the birth of the problem as such:
“In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive. Opioid overdose rates began to increase. In 2015, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid. That same year, an estimated 2 million people in the United States suffered from substance abuse disorders related to prescription opioid pain relievers, and 591,000 suffered from a heroin use disorder (not mutually exclusive).”
According to that report, between 21 and 29 percent of patients prescribed opioids for chronic pain misuse them, and between 8 and 12 percent develop an opioid use disorder. Of those who misuse prescription opioids, 4 to 6 percent transition to heroin, and close to 80 percent of people who use heroin first misused prescription opioids.
Heroin. Of all things, heroin.
In 2014, then-Point reporter Maria Counts wrote a three-part series on heroin infiltrating our little community, and it did not come in with a whisper — it came in like a screaming banshee.
Ocean View Police Chief Ken McLaughlin described at that time how heroin popped up here seemingly overnight.
“I had only actually seen or been involved in one or two heroin arrests in the first 22 years of my career here in Sussex County,” he said. “I personally always considered that to be a drug associated with major metropolitan areas, like Baltimore or New York City. It wasn’t something that we saw here in our resort community.
“It was unusual in this part of the county five years ago to come across heroin and make an arrest,” he noted. “Now it’s commonplace. I personally am very shocked at the number of cases we hear about in Sussex County and am saddened by it. I hope it’s not a trend that stays with us.”
It has, to McLaughlin’s chagrin, and to the dismay of everyone who lives here. Really, to anybody who lives anywhere in this country, as this epidemic shows no preference in race, economic background, gender or education. It is a soul-sucking, parasitic creature that continues to bring death and heartbreak everywhere it goes.
This is not a Republican problem. It is not a Democrat problem. It is not a Christian problem, or an LGBTQ problem. It is a human-being problem, initiated by other human beings for the sake of profit, and extended to other human beings who are and have been destroyed by contact, as well as others who have been exposed to the contact second-handed.
Raise your hand if you have a loved one fighting an addiction to opioids. Raise another if you have lost a loved one to the addiction of opioids.
That’s a lot of hands. And a lot of hurt that should have been avoided.