In Harvey, Butler and McPherson counties, 4 million pills were sent to pharmacies and physicians in 2006, a GateHouse Media analysis of the data show. In 2012, the area received 6.8 million, an increase of 70 percent in seven years.
For the first time ever, the public can see details of who manufactured pain pills and which pharmacies stocked them, revealing exactly what drug companies knew as they flooded communities with opioids that fueled a national epidemic.
After a yearlong court battle, The Washington Post and HD Media, which owns the Charleston Gazette-Mail, won public access to a key Drug Enforcement Administration database in July.
The database, which The Washington Post released publicly last week, details 380 million times between 2006 and 2012 that manufacturers sold opioids to pharmacies, physicians or other distributors — including shipments of more than 875 million pills to Kansas alone.
The Washington Post narrowed the data to oxycodone and hydrocodone pills because research has shown those common prescriptions were the painkillers most often diverted into the black market.
Here in Harvey, Butler and McPherson counties, 4 million pills were sent to pharmacies and physicians in 2006, a GateHouse Media analysis of the data show. In 2012, the area received 6.8 million, an increase of 70 percent in seven years.
The shipments averaged out to 47.7 pills per person each year in Butler County, 38.7 in Harvey County and 34.3 in McPherson County. The state average was slightly lower than the national average of 36 pills per year after excluding Leavenworth County, where there is a Veterans Affairs Department distribution pharmacy that serves the greater region. That’s compared to the top five counties in the United States, all of which saw annual rates of more than 200 pills per person.
The government and drug industry opposed the release of the data and won the initial court case to block it, but the news organizations prevailed on appeal.
The media groups also convinced the court to unseal depositions and internal documents, such as emails, that show companies’ internal push to increase sales even while opioid-related deaths soared.
Nationally, about 144,000 people died from opioid overdoses between 2006 and 2012 — including 883 people in Kansas — according to data from the Centers for Disease Control and Prevention. An additional 211,000 people — of whom 807 were in Kansas — died in the five years since then.
The death rate here remains a third of the national average with 5.1 opioid overdose deaths per 100,000 people in 2017. That is 10 times lower than the death rate seen in West Virginia, which went from having one of the nation’s lowest rates to its highest because of the epidemic.
Lawsuits related to drug companies’ role in those deaths already are the largest in Amerian history with settlements surpassing those made with tobacco companies in the 1980s.
Some of the largest drug companies already have paid more than $1 billion in federal fines and even more to states and counties who sued. Exact deals remain to be reached with most filers.
But at least one pharmaceutical trade association executive appeared to blame the federal Drug Enforcement Association for the epidemic.
“The DEA has been the only entity to have all of this data at their fingertips, and it could have used the information to consistently monitor the supply of opioids and when appropriate, proactively identify bad actors,” said John Parker, senior vice president of the Healthcare Distribution Alliance, in an email to GateHouse Media.
Healthcare Distribution Alliance is the national trade association representing pharmaceutical distributors. Parker emphasized that HDA members followed rules requiring them to report sales to federal officials.
“Unlike the DEA,” Parker said, “distributors have no authority to stop physicians from writing prescriptions, nor can they take unilateral action to halt pharmacies’ ability to dispense medication.”
The Post reported that oxycodone and hydrocodone pills accounted for three-quarters of all opioid shipments to pharmacies over the seven years of tracking. The newspaper released the original data, as well as an easy-to-use search tool, writing that they want “to help the public understand the impact of years of prescription pill shipments on their communities.”
Communities have long known the tally of resulting overdose deaths. But until now, Americans could not know how many pain killers had been sent to their communities because public officials and drug company attorneys sought to keep the information secret.
The deaths came in three waves.
Manufacturers saturated towns with more painkillers than reasonably could be used for medical purposes, and the pills were diverted to the black market and abused. When access to medical-grade opioids was cut off amid crackdowns and public pressure, people had to switch to street opioids, like heroin, to prevent debilitating withdrawal.
Overdoses spiked even more as Mexican cartels began mixing often-tainted Chinese fentanyl into heroin and then began selling that powerful opioid on its own.
Court documents show that companies ran marketing campaigns with distorted facts about painkillers' effectiveness and aggressively pushed for increased sales even when they knew more pills were being sold than could legally be used. At least one executive was criminally convicted for trying to bribe doctors to increase pain killer sales.
Internal documents freed as part of the Washington Post’s legal case and shared with the public by the newspaper show that many high-level company officials focused on following the letter of reporting laws but did not see themselves as having a broader duty to halt suspicious sales even as overdose deaths grew.
One of the nation’s largest distributors said as much in an August 2018 court deposition.
“Cardinal Health does not have an obligation to the general public,” said Vice President Jennifer Norris when asked about the opioid epidemic. “Cardinal Health has an obligation to perform its duties in accordance with the law, the statute, regulations, and guidance.”
An email exchange a decade earlier illustrates the sales-at-any-cost attitude prevalent throughout the documents newly unsealed by the court.
In January 2009, a national account manager for Mallinckrodt told a vice president of KeySource Medical that he had just shipped the company 1,200 bottles of 30mg oxycodone tablets. That particular dosage is widely preferred by illicit users and drug traffickers.
“Keep ’em comin’!” said Steve Cochraneof KeySource. “Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are. . .”
Victor Borelli, from Mallinckrodt, replied: “Just like Doritos keep eating, we’ll make more.”