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More than 100 billion pain pills saturated US over nine years

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Newly disclosed federal drug data shows that more than 100 billion doses of oxycodone and hydrocodone were shipped nationwide from 2006 through 2014 - 24 billion more doses of the highly addictive pain pills than previously known to the public.

The data, which traces the path of every pain pill shipped in the United States, shows the extent to which opioids flooded the country as deaths from the epidemic continued to climb over nine years.

The Washington Post and the company that owns the Charleston Gazette-Mail in West Virginia first obtained the data, collected by the Drug Enforcement Administration, from 2006 through 2012 after waging a year-long legal fight. In July, The Post reported that the data revealed that the nation's drug companies had manufactured and distributed more than 76 billion pain pills.

The two additional years' worth of information - 2013 and 2014 - was recently posted by a data analytics company managed by lawyers for the plaintiffs in a massive lawsuit against the opioid industry.

"In excess of 100 billion pills is simply jaw-dropping," said Peter Mougey, a lawyer for plaintiffs from Pensacola, Florida. "The data demonstrates that every community in the country has been negatively impacted."

The newly released data, which traces the path of pills from manufacturers and distributors to pharmacies across the country, confirms again that six companies distributed the vast majority of the pain pills.

McKesson Corp., Cardinal Health, Walgreens, AmerisourceBergen, CVS and Walmart accounted for 76% of the oxycodone and hydrocodone pills that were shipped between 2006 and 2014, according to an analysis by The Post. The new data will be added to the database of pills previously published by the The Post.

Three manufacturers still accounted for 85% of the pills: SpecGx, a subsidiary of Mallinckrodt; Actavis Pharma; and Par Pharmaceutical, a subsidiary of Endo Pharmaceuticals.

The volume of pills distributed skyrocketed as the epidemic claimed more lives. From 2006 through 2014, more than 130,000 Americans died from prescription opioids.

The number of pills shipped went from 8.4 billion in 2006 to 12.8 billion in 2011. Pill distribution started to decline slightly in 2012, and the additional data shows that, by 2014, the number of pills distributed was 11.8 billion.

The decline in pills distributed coincides with DEA enforcement against some of the biggest names in the drug industry, including CVS, Walgreens, McKesson and Cardinal.

The DEA accused the companies of not reporting suspicious orders of pain pills to the federal government and shipping the pills even after the companies had been warned by the DEA and some of them had been fined, according to agency records.

The new data further confirms the states that were flooded with the most opioids per person: West Virginia with 66.8 pills per person per year, Kentucky with 63.6, South Carolina with 60.9 and Tennessee with 59. West Virginia also had the highest prescription opioid death rate during the nine-year period.

The DEA data is drawn from a database known as ARCOS, or the Automation of Reports and Consolidated Orders System. It reveals what each company reported to the DEA about the pills it distributed day by day, town by town.

It is at the center of a sprawling lawsuit pending in federal court in Cleveland, where nearly 2,500 towns, cities, counties and tribal nations have sued two dozen drug manufacturers, distributors and pharmacies for allegedly fueling the deadliest drug epidemic in U.S. history.

In October, several companies reached a $260 million settlement with two Ohio counties. The remaining lawsuits are pending.

The companies have blamed the opioid epidemic on overprescribing by doctors and pharmacies, and on customers who abused the drugs. The companies also have said they were working to supply the needs of patients with legitimate prescriptions desperate for pain relief.

U.S. District Judge Dan Aaron Polster, who is overseeing that case, allowed the plaintiffs and defendants to see the DEA data from 2006 through 2014 under a protective order, shielding it along with tens of thousands of court records from the public view. The Post and the Gazette-Mail sued to gain access to the material and won the court fight in July.

After the news organizations sued, Polster released the DEA data through 2012, but he withheld the data from 2013 and 2014. The drug companies had argued that the release of that data could damage their competitive advantage, and the Justice Department warned that the newer data could compromise ongoing investigations.

Lawyers for the municipalities have accused drug manufacturers, wholesalers and pharmacies of fanning the opioid epidemic by producing, distributing and dispensing tens of billions of pain pills. The companies have paid more than $1 billion in fines to the Justice Department and Food and Drug Administration over opioid-related claims, and hundreds of millions more to settle state lawsuits.

Settlements with the Justice Department were frequently accompanied by agreements that kept details of the cases hidden from the public.

Taken together, the data and the documents provide the public with an unprecedented road map to the opioid epidemic.

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