This page was updated Sept. 12, 2023, to add data for 2015 through 2019 that was released as part of a court case.
For the first time, Americans can see the rise — and fall — of legal opioids entering their community. A database maintained by the Drug Enforcement Administration that tracks every single pain pill sold in the United States, tracing the path from manufacturers and distributors to pharmacies in every town and city, is now public through 2019, the tail end of the pain pill crisis.
These records provide an unprecedented look at the surge of legal pain pills that fueled the prescription opioid epidemic, which resulted in more than 210,000 overdose deaths during the 14-year time frame ending in 2019. It also sparked waves of an ongoing and raging opioid crisis first fueled by heroin and then illicit fentanyl.
The Washington Post sifted through 760 million transactions from 2006 through 2019 that are detailed in the DEA’s database and specifically focused on oxycodone and hydrocodone pills, which account for three-quarters of all opioid dosages shipped to pharmacies during that time. The Post is making this data available at the county and state levels to help the public understand the impact of years of prescription pill shipments on their communities.
Jump to the data for your community
A county-level analysis shows where the most oxycodone and hydrocodone pills were distributed across the country over that time — more than 145 billion in all.
Number of pills distributed per person, per year
Average yearly total, by county, 2006 through 2019
Hover over a county to view details
The Post initially gained access to the DEA’s Automation of Reports and Consolidated Orders System, known as ARCOS, as the result of a court order in July 2019. The Post and HD Media, which publishes the Charleston Gazette-Mail in West Virginia, waged a year-long legal battle for access to the database, which the government and the drug industry had sought to keep secret. The initial release of data covered 2006 to 2012, and was later updated through 2014.
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The Post’s data and interactive maps illustrate how much hydrocodone and oxycodone went to individual states and counties, and which companies and distributors were responsible.
Find the data for where you live
The Post analysis shows that the volumes of the pills handled by the companies climbed as the epidemic surged, increasing by 52 percent from 8.4 billion in 2006 to 12.8 billion in 2011. Pill distribution started to decline slightly in 2012, and additional data reveals that the number of pills distributed was down 45 percent from its peak by 2019, to less than 7.1 billion. Yearly county-level maps show how the influx of pills spread and then receded.
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From 2006 through 2014, six companies distributed 76 percent of the country’s oxycodone and hydrocodone pills: McKesson, Walgreens, Cardinal Health, AmerisourceBergen, CVS and Walmart, according to a Post analysis. In the five years that followed, the distribution market consolidated further, with just three companies — AmerisourceBergen, McKesson and Cardinal Health — shipping 83 percent of pills nationwide.
From 2006 through 2014, three companies manufactured about 85 percent of the opioids: SpecGx, a subsidiary of Mallinckrodt; Actavis; and Par Pharmaceutical, a subsidiary of Endo. In the following five years, the three companies’ shares fell to 57 percent of oxycodone and hydrocodone pills as the supply chain diversified. The most recent year of data, 2019, shows that SpecGx still leads the pack, followed by Purdue Pharma and KVK Tech.
Comparing county-level maps of prescription opioid overdose deaths and pill shipments reveal a virtual opioid belt of more than 90 counties stretching southwest from Webster County, W.Va., through southern Virginia and ending in Monroe County, Ky. This swath includes 18 of the top 20 counties ranked by per-capita prescription opioid deaths nationwide and 15 of the top 20 counties for opioid pills distributed per capita.
Maps showing “Number of pills per person per year” and “Opioid deaths”
Number of pills per person per year
Average county yearly total 2006 through 2019
Prescription opioid deaths per year
Cumulative opioid death rate 2006 through 2019
Source: Data compiled by the DEA and CDC
and analyzed by The Post
Number of pills per person per year
Average county yearly total 2006 through 2019
Prescription opioid deaths per year
Average yearly opioid death rate 2006 through 2019
Source: Data compiled by the DEA and CDC
and analyzed by The Post
Number of pills per person per year
Prescription opioid deaths per year
Average county yearly total 2006 through 2019
Average yearly opioid death rate 2006 through 2019
Source: Data compiled by the DEA and CDC and analyzed by The Post
Number of pills per person per year
Prescription opioid deaths per year
Average county yearly total 2006 through 2019
Average yearly opioid death rate 2006 through 2019
Source: Data compiled by the DEA and CDC and analyzed by The Post
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About this story
The Post analyzed figures from the DEA’s ARCOS database, from 2006 to 2019.
Data was processed by SLCG Economic Consulting.
Data analyzed includes only shipments from sales of oxycodone and hydrocodone pills to retail pharmacies, chain pharmacies and practitioners. The entire database tracks 14 different opioids, including oxycodone and hydrocodone in other forms such as capsules, but The Post focused on tablet pills, which dominated the market and were most often diverted into illegal use. Several major online pharmacies based in specific cities were not included in the analysis of county-level pills, because most of their pills were shipped elsewhere.
This page, with data from 2006 to 2012, originally published July 16, 2019. Data from 2013 and 2014 was added on January 17, 2020.
Data analysis: Steven Rich, Aaron Williams and Andrew Ba Tran
Graphics, design and development: Armand Emamdjomeh, Chris Alcantara, Jake Crump, Jason Holt, Kevin Schaul, Paige Moody, Patrick Haney, Tim Meko
Editing: Danielle Rindler, Matt Callahan, Meghan Hoyer and Trish Wilson.
Source link: https://www.washingtonpost.com/investigations/interactive/2023/opioid-epidemic-pain-pills-sold-oxycodone-hydrocodone/