A new analysis of federal data on opioid shipments published last week by a court in Ohio shows an amazing statistic.
According to the Associated Press, in 2012 enough medication was shipped to the US for every adult and every child in the country to ensure almost 20 days of care.
That was just the average: some counties in the impoverished Ruster Belt could have provided every citizen with 100 days of care this year.
The news agency also found that even as the number of pills distributed decreased, effectiveness increased as doctors prescribed stronger medications.
It shows that not only the number of pills sent has increased. The actual amount of opioids prescribed and consumed increased,” Anna Lembke, a professor at Stanford University who researches opioids and serves as a paid expert for plaintiffs in the litigation, the AP said.
“We know that the higher the dose of the prescribed opioids and the longer the patients are with them, even in legitimate pain conditions, the more likely they are to become addicted.
Shipments of opioid painkillers in the U.S. rose from 2006 to 2012 as the country’s addiction crisis accelerated, as new federal data show.
Reports published in a wide-ranging opioid case show that companies distributed 8.4 billion hydrocode and oxycodone tablets to commercial pharmacies in 2006 and 12.6 billion in 2012 – an increase of over 50 percent.
In 2012, as the number of deaths from the country’s opioid crisis increased, pharmaceutical companies shipped enough of the powerful and addictive painkillers for every man, woman and child in the U.S. to be treated for nearly 20 days.
The AP found that the total amount of opioid drugs shipped to pharmacies, medical services and hospitals increased by 55% between 2006 and 2012. The number of pills also increased significantly during this period, but the increase was lower at around 44%. (The amount of drugs was calculated using a standard measure of efficacy known as the morphine milligram equivalent (MME).
In 2006 and 2007, districts at the top of the list of those receiving the most opioids were scattered across the eastern half of the US. By 2012, they were all in the Appalachian region. And the numbers rose dramatically.
For example, in 2006 Tennessee’s Hamblen County received the most opioid drugs per person in the country – about 70 days of a typical prescription for every man, woman and child. By 2012, the top county was Norton, Virginia, and the number of days worth of opioids was an amazing 134.
In calculating the drug days, the AP used 50 MMEs as daily doses. This is the upper limit above which the Centers for Disease Control and Prevention urges physicians to exercise caution.
The data comes from the Federal Drug Enforcement Administration’s collection of information from pharmaceutical companies on how controlled substances were distributed to pharmacies, physicians and hospitals. It is an important part of the case for some 2,000 state, local and tribal governments suing the industry over the opioid crisis.
The first of the federal trials, involving claims from the Cuyahoga and Summit districts in Ohio, is scheduled to begin in October.
Last week, a judge agreed to publish the data for 2006-2012. During this period, opioid overdose deaths in the U.S. rose from around 18,000 per year to more than 23,000. Since then, the number has doubled and opioids have overtaken car accidents as the leading cause of accidental death in the country.
Heroin and even stronger illegal drugs such as fentanyl drove the increase for most of the decade. Studies have shown that most new heroin users started with prescription drugs prescribed to them or someone else.
The plaintiffs in the lawsuits claim that drug companies overestimated the benefits of opioids and played down their addiction risk by persuading doctors to offer the drugs to more patients and in higher quantities.
The origins of the opioid crisis date back largely to the mid-1990s, when Purdue Pharma introduced OxyContin. Until then, opioids were usually reserved for surgical or cancer patients with extreme pain.
The government complaints also say that companies have violated the DEA directive by shipping orders, even if they considered them “suspicious” because they were much larger than normal.
For example, an e-mail chain from Purdue Pharma, the manufacturer of OxyContin, showed an employee marking an order from the pharmaceutical retailer Cardinal Health on 27 October 2009 at 4:15 p.m. because it was almost twice the size of the usual 12-week order for a certain dosage by the customer. The order was worth almost $293,000.
It was approved at 16:16, as the e-mails show.
The email was part of a new pool of industry documents published this week. They also include a transcript of a testy deposit earlier this year, in which an executive at Cardinal Health – one of the nation’s largest drug distributors – said the company has no obligation to.