Opioid distribution database shows rural counties inundated with pain pills in 2006-12; see data by county and drugstore

UPDATE: Paintsville (Ky.) Herald Editor Aaron Nelson took a look at the data and found that "Two pharmacies in Paintsville ranked number one and number four across the entire state of Kentucky for opioid shipments between 2006 and 2012." And he named the pharmacies in his story.

Washington Post map; click on the image to enlarge it or click here to view the interactive version.

Between 2006 and 2012, pharmaceutical companies distributed 76 billion doses of prescription pain medicine, "enough pills to supply every adult and child in the country with 36 each year," Scott Higham, Sari Horwitz and Steven Rich report for The Washington Post. But rural counties, especially in Appalachia, received some of the highest shares of pain pills per person.

Washington Post map; click on image to enlarge it.

UPDATE, July 18: The Post has updated the story to include a link to the raw data, a portal to search for data by county, a map showing opioid deaths from 2006-2012, and more.

That's according to a Drug Enforcement Administration database, made public for the first time, that tracks the path of every DEA-regulated pain medication in the U.S. County-level data shows the places that received the most pills, fueling the prescription opioid epidemic that resulted in nearly 100,000 deaths in that time period, the Post reports.

"The states that received the highest concentrations of pills per person per year were: West Virginia with 66.5, Kentucky with 63.3, South Carolina with 58, Tennessee with 57.7 and Nevada with 54.7. West Virginia also had the highest opioid death rate during this period," Higham, Horwitz and Rich report. "Rural areas were hit particularly hard: Norton, Virginia, with 306 pills per person; Martinsville, Va., with 242; Mingo County, West Virginia, with 203; and Perry County, Kentucky, with 175." The Post's Joel Achenbach has a close-up look at Norton.

Nearly half of the pills were distributed by three companies: McKesson, Walgreens and Cardinal Health. The top manufacturer was Mallinckrodt's SpecGx, with nearly 38 percent of the market.

Because the database is partly comprised of data that drug makers gave the DEA, it shows what they knew about the number of pills they were shipping at the epidemic's peak, the Post points out. Drug manufacturers, distributors and pharmacies must log and report each narcotic transaction, and are supposed to report suspiciously large or frequent orders to the DEA and withhold such shipments.

Nevertheless, nearly 2,000 communities, counties and Indian tribes have alleged in federal lawsuits that the drug companies filled suspicious orders and did not report them in order to maximize profits. The lawsuits were consolidated into one case, which is now larger in scope than the lawsuit against cigarette manufacturers in the 1980s, the Post reports.

The database was released Monday after the Post and HD Media, which publishes the Charleston Gazette-Mail, won a years-long legal battle to access documents and data from the ongoing litigation. The West Virginia newspaper won a Pulitzer Prize in 2018 for reporting on drug distribution, using other data.) The Post reports that the DEA, the Justice Department, and drug companies all fought hard against release of the data. The companies said the database would reveal information that could give competitors an unfair advantage, and the Justice Department said the data could compromise ongoing DEA investigations.

Post Executive Editor Marty Baron said, “The Post has invested tremendous legal and journalistic resources in obtaining, analyzing and presenting this database. But there is more work to be done — by us, by other journalists and by individuals seeking to learn what has transpired in their own communities. With this database on our site, many others can now contribute to a full understanding of the causes and impact of a devastating opioid epidemic.” Kristen Hare of The Poynter Institute opined, "This is a remarkable display of public service reporting performed by The Post. The information, available to every journalist in every corner of the country, can be used to impact, literally, every person in America."