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Billions of opioid pills have flowed into North Carolina since 2006, with millions ending up in Burke County, according to recent reporting from The Washington Post.

Now, where those pills came from and to where they were delivered have been revealed, thanks to two newspapers that fought to get access to the DEA’s database.

 

Fighting for data

Opioids have devastated families in Burke County through addiction, overdoses and death. Opioids have also cost the county and its taxpayers due to increases in those using social services, health department services, EMS, jails and law enforcement.

Burke County joined numerous other counties and municipalities throughout the U.S. in February 2018 when it filed a federal lawsuit against manufacturers and distributors of opioids to try to recoup some of the money it has spent for those increases in services.

For the first time, a database maintained by the Drug Enforcement Administration that tracks the path of every single pain pill sold in the United States — by manufacturers and distributors to pharmacies in every town and city — has been made public, The Washington Post says.

The Washington Post originally published its story “Drilling into the DEA’s pain pill database” on July 16. The story and data link can be found at https://wapo.st/2GHm26G.

The Post gained access to the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System, known as ARCOS, as the result of a court order. 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 Post says.

The data contains raw data on shipments of oxycodone and hydrocodone pills to chain pharmacies, retail pharmacies and practitioners, according to The Washington Post.

The Post says it has been asked why it doesn’t have more recent data. It says the DEA only produced data from 2006 through 2012 in the case. The Post says it knows that 2013 and 2014 data exists, but it has not been able to get access because of the ongoing court case in Ohio. The Post is still fighting for its release, it says.

 

The data for Burke

From 2006 to 2012 there were 43,093,145 prescription pain pills that came into Burke County, enough for 68 pills per person per year, according to The Post and database. It says 11,171,730 of those pills were distributed by Cardinal Health and 17,526,200 were manufactured by SpecGx LLC.

The other manufacturers in the top 5 whose pills ended up in Burke County were:

» Actavis Pharma Inc. at 10,526,100

» Par Pharmaceutical at 8,950,050

» Amneal Pharmaceuticals LLC at 2,695,000

» Purdue Pharma LP at 1,722,920

The other distributors in the top 5 who sent the pills to Burke County were:

» McKesson Corporation at 8,240,570 pills

» NC Mutual Wholesale Drug Co at 6,962,090

» CVS at 5,737,100

» Wal-Mart at 3,536,100

As for pharmacies in Burke County who received the pills, Table Rock Pharmacy in Morganton received the highest number of opioids at 4,463,010 pills, according to The Post and database.​

The others that round out the top 5 pharmacies in Burke County to receive the most opioid pills were:

» North Carolina CVS Pharmacy L.L.C. at 3,991,200 pills

» Wal-Mart Pharmacy 10-1060 in Morganton at 3,624,010 pills

» Jones Drugs Inc. in Morganton at 3,556,620 pills

» Drexel Drug Rite No. 1 in Drexel at 3,082,840 pills

 

From 2006 to 2012 there were 2,552,612,498 prescription pain pills supplied to North Carolina, according to The Post and database.

» Cardinal Health distributed the most pills in North Carolina at 542,161,824 over the period. NC Mutual Wholesale Drug Co . distributed 459,177,550 pills; CVS distributed 285,551,960 pills; Wal-Mart distributed 249,902,520 pills; and Walgreen Co . distributed 248,845,170 pills, according to the database.

» Omnicare Pharmacy of North, Hickory pharmacy received the highest number of pills at 9,202,680 pills, according to The Post and database.

» Manufacturer SpecGx LLC is responsible for more than 1.2 billion pills between 2006 and 2012, according to the database.

 

Burke in a cluster

In Burke County, there are more opioid prescriptions distributed than people. That was true in 2006 and the numbers have only increased.

According to the Centers for Disease Control and Prevention, data shows what makes Burke County a hotspot is the opioid prescription to person ratio.

The CDC shows there were 123.6 opioid prescriptions per 100 people written in Burke County in 2006. By 2010, that number had grown to 146.5 opioid prescriptions per 100 people, which means there are more opioids prescribed than there are people in Burke County.

The CDC shows the 2017 prescribing rate per 100 people in the county was 125.3 prescriptions.

In 2016, 151.5 prescriptions were written per 100 people in Burke County and in 2015, the Burke prescription rate was 154.9, according to the CDC.

And Burke County isn’t alone. The county is among a cluster of counties in the area that the CDC considers a hotspot for opioids, although the number of prescriptions did drop in 2017. The other counties in the hotspot cluster were Caldwell, Catawba and Cleveland counties.

The previous year the hotspot cluster that Burke was a part of also included Gaston and Lincoln counties and continued across the border into South Carolina in Cherokee and Union counties, according to the CDC. Another cluster in North Carolina is in the southeastern part of the state and crosses into South Carolina.

The CDC says North Carolina is among the states with statistically significant increases in drug overdose death rates from 2016 to 2017. The number of overdose deaths increased 22.3 percent in the state between 2016 and 2017, the CDC reports.  

 

The lawsuit

The lawsuits that have been filed across the country against the manufacturers and distributors of opioid drugs are an attempt for local and state governments to recoup some of the money spent due to opioid addiction.

J.R. Simpson, attorney for Burke County, said the first of the lawsuits in the U.S. is supposed to be starting trial in September in federal court in Ohio. But there is another lawsuit similar to the one in Ohio that may start in September in Nevada, he said.

The lawsuits have all been consolidated under a federal judge in Cleveland, Ohio , but they’re all separate lawsuits, Simpson said. He said when Burke’s lawsuit comes up it will be tried in the western district of federal court in North Carolina unless it’s settled beforehand.

Simpson said he believes the thinking among the law firm consortium that is the driving force behind the lawsuits, with the lead counsel being Baron & Budd P.C., is the lawsuits will keep moving forward and at some point the defendants may throw in their lots together and try to get all of these cases settled at one time.

“We’re just put on a wait-and-see type basis,” Simpson said.

Some of the manufacturers and distributors named as defendants in the lawsuit include AmerisourceBergen Drug Corporation, Cardinal Health Inc., McKesson Corporation, Johnson & Johnson, Purdue Pharma L.P., Purdue Pharma Inc., The Purdue Frederick Company Inc., Teva Pharmaceutical Industries, Cephalon Inc. and Ortho-McNeil-Janssen Pharmaceuticals.

It is AmerisourceBergen Drug Corporation, Cardinal Health and McKesson Corporation that plaintiff attorneys say has an 85 percent share of the opioid drug market. The yearly combined revenue of the three companies is $450 billion, according to attorneys in the Burke lawsuit.

The lawsuit says that AmerisourceBergen Drug Corporation, Cardinal Health and McKesson Corporation has been investigated and/or fined by the federal DEA for the failure to report suspicious orders.

A 60 Minutes story in late June dedicated a segment about the lawsuits against the opioid manufacturers and distributors. It interviewed Attorney Mike Moore, who is a lead attorney for the plaintiffs in the lawsuits. In the interview, he said success for him would be to find funding to provide treatment for the 2.5 million people who are dependent on opioids in the U.S. That would take billions of dollars, the segment said. Moore was the lead in the lawsuits against big tobacco and won $250 billion, according to 60 Minutes and Moore.

Moore called the opioid crisis in the country a “pill spill” in the 60 Minutes segment. The DEA database was released to attorneys in the lawsuits in the spring and can prove which distributor delivered to which pharmacies in the country, according to the segment. Moore said in the segment that to be affective the plaintiffs need to win at least $100 billion to pay for treatment, prevention and education.

Sharon McBrayer is a staff writer and can be reached at smcbrayer@morganton.com or at 828-432-8946.

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