How many pain pills went to your pharmacy?

Nearly 83,000 pharmacies are at the front lines of the opioid crisis in America.

The pharmacies and the amount of pain pills they handled are revealed in a previously unreleased database maintained by the Drug Enforcement Administration. The database tracks the path of more than 70 billion pills that contain oxycodone and hydrocodone from manufacturers to retail pharmacies.

While the crisis makes it clear that many of the opioids were diverted to the black market, the DEA database obtained by The Post does not track the pills after they reach the pharmacies. There are legitimate reasons small pharmacies can have outsize volumes, including proximity to surgical centers.

As overdoses soared, nearly 35 billion opioids — half of distributed pills — were handled by 15 percent of pharmacies

The Post has analyzed and mapped the pharmacy data, which covers 2006 through 2012. It provides a first-ever, granular look at the number and type of pills that flowed into pharmacies and their local communities during a period in which nearly 100,000 people died nationwide from overdoses.

The map below shows how many opioid pills were handled by retail and chain pharmacies, as well as how many pills were shipped to pharmacies near a specific address.

Circles in the map are scaled by the total number of pills shipped to each pharmacy from 2006 through 2012.

Circles are colored by the total number of pills per person within a five-mile radius of the pharmacy per year.*

0

25

75

150

300+

Use two fingers to pan around the map.
Pinch to zoom.

This analysis used two measures for comparison: the number of pills per person per year within a five- to 10-mile radius of each pharmacy and the cumulative number of pills per person based on the county population.

Comparing the yearly pill count within a smaller radius shows how many pills were within local communities across the county. However, measuring the total pill count available within five to 10 miles does not account for people who may travel further distances to acquire prescription pills. To address this, The Post analysis also looked at the number of pills per person within the county because counties offer a larger geographic comparison.

To study the pharmacies at the county level, The Post examined the total number of pills that contained oxycodone and hydrocodone distributed to each pharmacy in a county from 2006 through 2012, as well as the populations of those counties.

Pharmacies with the most pills per person, based on county population, 2006-2012

Click on a column to sort the table.

Pharmacy Total Pills Pills per person per year

SHEARER DRUG

CLINTON COUNTY, KY

6,778,550

96

HARDIN COUNTY DISCOUNT PHA

HARDIN COUNTY, IL

2,789,740

90

ARNZEN'S KAMIAH DRUG

LEWIS COUNTY, ID

2,298,640

88

BOONEVILLE DISCOUNT DRUGS

OWSLEY COUNTY, KY

2,850,040

86

C & R CLINIC PHCY

MORTON COUNTY, KS

1,916,920

85

GLENN'S APOTHECARY

CRITTENDEN COUNTY, KY

5,171,800

80

SMITH COUNTY DRUG CENTER INC.

SMITH COUNTY, TN

9,508,190

72

STROSNIDER

MINGO COUNTY, WV

13,168,350

70

MAIN STREET PHARMACY

COMANCHE COUNTY, KS

915,740

70

HOWARD'S DRUGS

LAKE COUNTY, OR

3,706,210

68

R&K PHARMACY INC.

POLK COUNTY, TN

7,627,625

66

SAFEWAY INC.

MINERAL COUNTY, NV

2,175,110

65

BOYDS FAMILY PHARMACY

EMERY COUNTY, UT

4,843,750

65

MK STORES INC.

LUCE COUNTY, MI

3,029,550

65

CLINIC PHARMACY

HARMON COUNTY, OK

1,294,890

65

HOOK-SUPERX LLC

BLACKFORD COUNTY, IN

5,843,000

64

CAPPS PHARMACY INC.

CUMBERLAND COUNTY, KY

3,106,950

64

VALUE-MED INC.

JOHNSON COUNTY, KY

10,449,480

64

AMPHARM INC.

DECATUR COUNTY, TN

5,054,570

62

POMEROY PHARMACY INC.

GARFIELD COUNTY, WA

958,300

62

HOMETOWN PHARMACY

LESLIE COUNTY, KY

4,935,500

61

DAVIDSON DISCOUNT DRUGS

PICKETT COUNTY, TN

2,150,990

61

THREE FORKS APOTHECARY LLC

LEE COUNTY, KY

3,307,670

61

DIXON DRUG

GREELEY COUNTY, KS

508,230

58

PRESCRIPTION CENTER INC.

BUTLER COUNTY, KY

5,128,760

57

DBA MEDICINE CABINET PHARMACY

JOHNSON COUNTY, KY

9,183,940

56

MIKE'S PHARMACY

GRUNDY COUNTY, TN

5,490,990

56

THRIFTY PAYLESS INC.

MODOC COUNTY, CA

3,664,970

55

DONALDSON PHARMACY INC.

CLAY COUNTY, TN

2,975,970

54

BURDEN DRUG CTR INC.

FENTRESS COUNTY, TN

6,680,940

54

DAVIS-FLECK DRUGS

SIERRA COUNTY, NM

4,448,100

53

ZION PHARMACY

KANE COUNTY, UT

2,473,500

52

CITY DRUG STORE

CHOCTAW COUNTY, OK

5,427,370

51

SPECIALIZED PHARMACY SERVICES

OGEMAW COUNTY, MI

7,723,580

51

RIGBYS PHARMACY INC.

LEMHI COUNTY, ID

2,775,100

51

FAMILY DISCOUNT PHARMACY INC.

LOGAN COUNTY, WV

12,849,040

51

STAR DRUG

HUERFANO COUNTY, CO

2,472,350

50

MOUNT VERNON DRUG

ROCKCASTLE COUNTY, KY

5,848,170

49

HARTSVILLE PHARMACY

TROUSDALE COUNTY, TN

2,645,530

49

ADDISON DRUG

DE BACA COUNTY, NM

671,600

49

LYON DRUG STORE

LYON COUNTY, KY

2,835,670

48

SAFEWAY INC.

PEND OREILLE COUNTY, WA

4,337,130

48

WAL-MART PHARMACY 10-2562

SHERMAN COUNTY, KS

1,990,640

47

HURLEY DRUG CO. INC.

MINGO COUNTY, WV

8,890,370

47

TUG VALLEY PHARMACY LLC

MINGO COUNTY, WV

8,827,860

47

MINERAL PHARMACY INC.

MINERAL COUNTY, MT

1,346,480

46

WHITE DRUG #55

ADAMS COUNTY, ND

758,270

46

MEADOW VALLEY PHARMACY

LINCOLN COUNTY, NV

1,602,590

46

DOYLE HIGH'S THE DRUG STORE

HASKELL COUNTY, TX

1,855,910

46

HOOK-SUPERX LLC

MARTIN COUNTY, IN

3,308,020

46

DILLON PHARMACY

PRATT COUNTY, KS

3,071,960

46

JONES HOMETOWN PHARMACY

LEWIS COUNTY, TN

3,764,000

45

HOOK-SUPERX LLC

STARKE COUNTY, IN

7,376,300

45

VICKLUND PHARMACY

HOT SPRINGS COUNTY, WY

1,436,800

44

PRUITTHEALTH PHARMACY SERVICES INC. - TOCCOA

STEPHENS COUNTY, GA

7,881,400

44

LOST RIVER DRUG

BUTTE COUNTY, ID

860,950

44

VILAS PHARMACY OF GETTSBURG

POTTER COUNTY, SD

701,060

43

KRIEN PHARMACY INC.

CHEYENNE COUNTY, KS

834,280

43

PEJ INC.

BREATHITT COUNTY, KY

4,317,280

43

USA DRUG AT ARCADIA VALLEY

IRON COUNTY, MO

3,146,730

43

MOORE DRUG INC.

JEFFERSON COUNTY, OK

1,904,110

43

WAYNE COMMUNITY HEALTH CENTER

WAYNE COUNTY, UT

776,600

42

LARRY'S DRIVE-IN PHARMACY INC.

BOONE COUNTY, WV

7,227,600

42

ALLEN DRUG

ONEIDA COUNTY, ID

1,206,430

41

HOFFMAN DRUG

LINCOLN COUNTY, CO

1,564,100

41

MILLS PHARMACY

LANDER COUNTY, NV

1,548,710

41

RICE DRUGS INC.

OHIO COUNTY, KY

6,716,610

40

MED-CARE PHARMACY

MORRIS COUNTY, TX

3,680,930

40

PIONEER FAMILY PHARMACY #103

OSCODA COUNTY, MI

2,472,160

40

HAMPTON MEDICAL PHARMACY

CALHOUN COUNTY, AR

1,522,950

39

FAMILY PHARMACY

WILBARGER COUNTY, TX

3,764,460

39

SCOTT CITY PHARMACY CHARTERED

SCOTT COUNTY, KS

1,324,000

39

EUREKA PHARMACY

GREENWOOD COUNTY, KS

1,877,990

39

REPUBLIC DRUG STORE

FERRY COUNTY, WA

2,051,960

39

WISE DRUG INC.

GRAHAM COUNTY, KS

727,000

39

FRUTH PHARMACY INC.

MASON COUNTY, WV

7,317,220

39

CAMPTON PHARMACARE INC.

WOLFE COUNTY, KY

1,983,500

39

ECK DRUG & GIFT

JEFFERSON COUNTY, OK

1,748,280

39

BEAVER DRUG

BEAVER COUNTY, UT

1,724,070

39

RITE AID OF TENNESSEE INC.

CLAY COUNTY, TN

2,129,980

39

GORDON DRUG CO. INC.

WILKINSON COUNTY, GA

2,625,475

39

RANCHLAND DRUG

MELLETTE COUNTY, SD

547,300

39

MINNEOLA PHARMACY INC.

CLARK COUNTY, KS

588,650

38

WOODSON'S PHARMACY

CANNON COUNTY, TN

3,623,860

38

BLAND COUNTY PHARMACY

BLAND COUNTY, VA

1,815,480

38

KINGMAN DRUG STORE

KINGMAN COUNTY, KS

2,092,790

38

CITY PHARMACY OF JUNCTION INC.

KIMBLE COUNTY, TX

1,200,790

38

WEATHERS DRUGS

TODD COUNTY, KY

3,227,880

38

NELSON'S CITY DRUG

GRANT COUNTY, OR

1,909,610

38

GENE LAFITTE PHARMACY

JOHNSTON COUNTY, OK

2,821,190

38

KIOWA DRUG

KIOWA COUNTY, CO

399,000

37

SUPER DISCOUNT DRUGS

OVERTON COUNTY, TN

5,649,930

37

ELDER-CARE PHARMACY

PULASKI COUNTY, GA

2,936,000

37

FRED'S

TROUSDALE COUNTY, TN

1,992,860

37

ALMA DISCOUNT PHARMACY

BACON COUNTY, GA

2,797,830

37

MURRAY DRUG CO. INC.

CLINCH COUNTY, GA

1,761,880

37

BERINGER DRUG CENTER

GALLATIN COUNTY, KY

2,144,650

37

PANGUITCH DRUG CO.

GARFIELD COUNTY, UT

1,245,600

37

EVANS DRUG CO.

FULTON COUNTY, KY

1,751,200

36

COMMUNITY DRUG OF MANCHESTER

CLAY COUNTY, KY

5,691,230

36

Pharmacies in cities that are also considered counties, most of which are in Virginia, are not included.

The data is extracted from the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System, known as ARCOS. 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 fought to keep secret. A judge ordered its release on July 15.

Last month, the Post published a version of the full database, which shows how many pills containing hydrocodone and oxycodone went to individual states and counties, and which companies and distributors were involved.

The Post’s analysis of the data found that a small percentage of pharmacies received nearly half of the pills distributed in the United States between 2006 and 2012.

From 2006 through 2012,

15 percent of pharmacies ...

1,000 pharmacies

... received 48 percent

of pain pills

100,000,000 pills

Source: Washington Post analysis of Drug Enforcement

Administration data

From 2006 through 2012, 15 percent

of pharmacies ...

1,000 pharmacies

... received 48 percent of pain pills

100,000,000 pills

Source: Washington Post analysis of Drug Enforcement Administration data

From 2006 through 2012, 15 percent of pharmacies ...

1,000 pharmacies

... received 48 percent of pain pills

100,000,000

pills

Source: Washington Post analysis of Drug Enforcement Administration data

From 2006 through 2012, 15 percent of pharmacies ...

1,000 pharmacies

... received 48 percent of pain pills

100,000,000

pills

Source: Washington Post analysis of Drug Enforcement Administration data

Other findings include:

America’s largest drug companies distributed billions of oxycodone and hydrocodone pain pills across the country between 2006 and 2012. Just six companies distributed 75 percent of the pills during this period.

Opioid death rates soared in the communities that were flooded with pain pills. The national death rate from opioids was 4.6 deaths per 100,000 residents. But the counties that had the most pills distributed per person — many in West Virginia, Kentucky and southwest Virginia — experienced more than three times that rate on average.

Internal documents show the pressure within drug companies to sell opioids in the face of numerous red flags during the height of the epidemic. The documents also show how some employees were concerned about the huge volume of pain pills streaming across the nation.

• While drugmaker Purdue Pharma has borne the brunt of public criticism for inventing and deceptively marketing OxyContin, records show a handful of obscure generic-drug manufacturers were selling the bulk of the opioid pills flooding the country.

Armand Emamdjomeh

Armand Emamdjomeh makes data visualizations, maps and graphics. Before coming to The Post, he was Deputy Director of Data Visualization at the Los Angeles Times and an alum of the L.A. Times Data Desk.

Andrew Ba Tran

Andrew Ba Tran is an investigative data reporter. Tran shared in winning the Pulitzer Prize for Investigative Reporting in 2018.

Aaron Williams

Aaron Williams is an investigative data reporter who specializes in data analysis and visualization for The Washington Post. Before joining the investigative team he was a reporter for the Post graphics desk. He previously covered housing, campaign finance and police for the San Francisco Chronicle and the Center for Investigative Reporting.

Tim Meko

Tim Meko designs and develops maps, data visualizations and explanatory graphics. Before coming to The Post, he led the visuals team at the Urban Institute and was an infographics artist at the Columbus Dispatch.

Danielle Rindler

Danielle Rindler is an editor at The Washington Post, where she focuses on immersive visual storytelling. Before joining the Post in 2014, she was a designer at the Arizona Republic.

Additional data analysis by Steven Rich. Additional development by Jason Holt. Editing by David Fallis.

About this story

The Washington Post analyzed data from the Drug Enforcement Administration's Automation of Reports and Consolidated Orders System, known as ARCOS, from 2006 to 2012.

Data analyzed includes only shipments from sales of oxycodone and hydrocodone pills to retail and chain pharmacies. This page does not include pills distributed to practitioners or hospitals. (Download the raw data here.) The entire database tracks a dozen different opioids, including oxycodone and hydrocodone, which make up three-quarters of the total pill shipments to pharmacies.

All population data are U.S. Census Bureau estimates from the 2008-2012 5-year American Community Survey provided by IPUMS NHGIS from the University of Minnesota.

Population estimates within five miles were calculated by taking the centroid (or geometric center) of each census block group, creating a 5-mile buffer radius around each pharmacy point and determining which centroids fell within the boundary of the radius. If none fell within 5 miles of the buffer radius, the estimate was adjusted to measure centroids within 10 miles.

Because block groups vary in size, it’s likely some centroids fell outside the buffer radius even if part of the block group is within it.

This analysis considers a pharmacy to have a large number of pills if the total number it received was is in the 90th percentile (or top 10 percent) for all pills distributed within the county it’s located in.

The Post manually reviewed all chain and retail pharmacies that averaged more than one million pills received a year and removed from the map mail-order pharmacies and hospitals that were misclassified as chain or retail pharmacies in the data. 80,000 pharmacies were geocoded by The Post using Google's Maps API after cleaning addresses registered in the ARCOS database. The Post manually geocoded nearly 3,000 pharmacies.

The business names of each pharmacy come directly from the DEA database as of 2012 and may not reflect the current branding displayed at each location. Where possible, The Post has included the DBA, or doing business as name associated with each business.

Originally published Aug. 12, 2019.

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