How many pain pills went to your pharmacy?

Nearly 90,000 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 100 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 2014. 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 2014.

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 2014, as well as the populations of those counties.

Pharmacies with the most pills per person, based on county population, 2006-2014

Click on a column to sort the table.

Pharmacy Total Pills Pills per person per year

SHEARER DRUG

CLINTON COUNTY, KY

8,938,110

98

HARDIN COUNTY DISCOUNT PHA

HARDIN COUNTY, IL

3,748,250

95

ARNZEN 'S KAMIAH DRUG

LEWIS COUNTY, ID

3,100,940

92

BOONEVILLE DISCOUNT DRUGS

OWSLEY COUNTY, KY

3,791,040

89

C & R CLINIC PHCY

MORTON COUNTY, KS

2,486,480

86

GLENN'S APOTHECARY

CRITTENDEN COUNTY, KY

6,446,800

77

SMITH COUNTY DRUG CENTER INC

SMITH COUNTY, TN

12,410,330

72

CAPPS PHARMACY INC

CUMBERLAND COUNTY, KY

4,470,150

72

CLINIC PHARMACY

HARMON COUNTY, OK

1,840,570

71

MAIN STREET PHARMACY

COMANCHE COUNTY, KS

1,201,140

71

CAMPTON PHARMACARE

WOLFE COUNTY, KY

3,076,200

71

HOWARD'S DRUGS

LAKE COUNTY, OR

4,943,350

70

STROSNIDER

MINGO COUNTY, WV

13,168,350

70

SAFEWAY INC

MINERAL COUNTY, NV

2,906,500

68

ANDERSON HEALTHCARE INC. BENKELMAN PHARMACY

DUNDY COUNTY, NE

527,000

66

HOOK-SUPERX

BLACKFORD COUNTY, IN

7,686,900

66

POMEROY PHARMACY INC

GARFIELD COUNTY, WA

1,307,490

65

HARTSVILLE PHARMACY

TROUSDALE COUNTY, TN

3,982,900

64

MK STORES INC

LUCE COUNTY, MI

3,815,750

64

DONALDSON PHARMACY INC

CLAY COUNTY, TN

2,975,970

63

AMPHARM INC

DECATUR COUNTY, TN

6,593,670

63

BOYDS FAMILY PHARMACY

EMERY COUNTY, UT

6,039,220

63

HOMETOWN PHARMACY

LESLIE COUNTY, KY

6,270,100

61

R&K PHARMACY INC

POLK COUNTY, TN

9,028,185

60

DAVIDSON DISCOUNT DRUGS

PICKETT COUNTY, TN

2,734,990

60

DIXON DRUG

GREELEY COUNTY, KS

663,230

59

MIKE'S PHARMACY

GRUNDY COUNTY, TN

7,373,710

59

THREE FORKS APOTHECARY

LEE COUNTY, KY

4,113,990

59

VALUE-MED INC

JOHNSON COUNTY, KY

12,049,330

57

RITE AID

MODOC COUNTY, CA

4,789,860

56

ADDISON DRUG

DE BACA COUNTY, NM

984,900

56

SPECIALIZED PHARMACY SERVICES

OGEMAW COUNTY, MI

10,697,100

55

CITY DRUG STORE

CHOCTAW COUNTY, OK

7,383,810

54

ZION PHARMACY

KANE COUNTY, UT

3,324,490

53

BURDEN DRUG CTR INC

FENTRESS COUNTY, TN

7,572,300

53

RIGBYS PHARMACY INC

LEMHI COUNTY, ID

3,699,100

52

PRESCRIPTION CENTER

BUTLER COUNTY, KY

5,990,360

52

THE MEDICINE SHOPPE

JACKSON COUNTY, OH

3,384,100

51

EUREKA PHARMACY

GREENWOOD COUNTY, KS

2,718,220

50

STAR DRUG

HUERFANO COUNTY, CO

3,130,950

50

DOYLE HIGH'S THE DRUG STORE

HASKELL COUNTY, TX

2,595,110

50

MEDICINE CABINET PHARMACY

JOHNSON COUNTY, KY

10,443,880

50

CAMPTON DISCOUNT DRUGS INC

WOLFE COUNTY, KY

1,425,850

49

DAVIS-FLECK DRUGS

SIERRA COUNTY, NM

5,278,100

49

WHITE DRUG #55

ADAMS COUNTY, ND

1,016,380

48

SAFEWAY INC

PEND OREILLE COUNTY, WA

5,556,130

48

KRIEN PHARMACY INC

CHEYENNE COUNTY, KS

1,189,540

48

LYON DRUG STORE

LYON COUNTY, KY

3,583,990

48

MEADOW VALLEY PHARMACY

LINCOLN COUNTY, NV

2,149,150

47

FAMILY DISCOUNT PHARMACY INC

LOGAN COUNTY, WV

15,466,240

47

ELK DRUG INC

COLUMBIA COUNTY, WA

754,890

47

MOUNT VERNON DRUG

ROCKCASTLE COUNTY, KY

7,198,810

47

RANCHLAND DRUG

MELLETTE COUNTY, SD

864,080

47

HOOK-SUPERX

MARTIN COUNTY, IN

4,332,120

47

TUG VALLEY PHARMACY

MINGO COUNTY, WV

9,823,650

46

MINERAL PHARMACY INC

MINERAL COUNTY, MT

1,712,380

46

WAL-MART PHARMACY 10-2562

SHERMAN COUNTY, KS

2,461,440

45

JONES HOMETOWN PHARMACY

LEWIS COUNTY, TN

4,882,420

45

LIESKE'S PHARMACY

FRANKLIN COUNTY, NE

720,530

45

SUPER SAV DRUG #2

SCOTT COUNTY, AR

2,521,600

45

DILLON PHARMACY

PRATT COUNTY, KS

3,895,760

45

HOOK-SUPERX

STARKE COUNTY, IN

9,394,900

45

ALLEN DRUG

ONEIDA COUNTY, ID

1,680,190

44

PRUITTHEALTH PHARMACY SERVICES INC - TOCCOA

STEPHENS COUNTY, GA

10,163,660

44

TAYLOR'S DISCOUNT PHARMACY

BELL COUNTY, KY

3,785,740

44

SCOTT CITY PHARMACY CHARTERED

SCOTT COUNTY, KS

1,895,200

44

VICKLUND PHARMACY

HOT SPRINGS COUNTY, WY

1,846,200

44

BATSON'S DRUG STORE

ELK COUNTY, KS

1,131,620

43

WAYNE COMMUNITY HEALTH CENTER

WAYNE COUNTY, UT

1,045,960

43

MOORE DRUG INC

JEFFERSON COUNTY, OK

2,490,010

43

MINNEOLA PHARMACY INC.

CLARK COUNTY, KS

851,570

43

K & D PHARMACY

BROOKS COUNTY, GA

2,750,660

43

RITE AID

CLAY COUNTY, TN

3,044,430

43

LOST RIVER DRUG

BUTTE COUNTY, ID

1,083,950

43

TMB CORPORATION

SEDGWICK COUNTY, CO

606,400

42

HOFFMAN DRUG

LINCOLN COUNTY, CO

2,040,700

42

RICE DRUGS INC

OHIO COUNTY, KY

8,875,880

41

PEJ INC

BREATHITT COUNTY, KY

5,298,280

41

MURRAY DRUG CO INC

CLINCH COUNTY, GA

2,534,380

41

WISE DRUG INC

GRAHAM COUNTY, KS

979,000

41

HURLEY DRUG COMPANY INC

MINGO COUNTY, WV

9,864,690

41

VILAS PHARMACY OF GETTSBURG

POTTER COUNTY, SD

856,260

41

WEATHERS DRUGS

TODD COUNTY, KY

4,522,920

41

ELDER-CARE PHARMACY

PULASKI COUNTY, GA

4,169,380

41

PIONEER FAMILY PHARMACY #103

OSCODA COUNTY, MI

3,224,360

41

WOODSON'S PHARMACY

CANNON COUNTY, TN

4,977,270

41

ECK DRUG & GIFT

JEFFERSON COUNTY, OK

2,325,220

40

LARRY'S DRIVE-IN PHARMACY INC

BOONE COUNTY, WV

8,985,700

40

MILLS PHARMACY

LANDER COUNTY, NV

2,008,170

40

KIOWA DRUG

KIOWA COUNTY, CO

541,500

40

BEAVER DRUG

BEAVER COUNTY, UT

2,307,170

40

KINGMAN DRUG STORE

KINGMAN COUNTY, KS

2,850,630

40

GORDON DRUG COMPANY INC

WILKINSON COUNTY, GA

3,481,315

40

FAMILY PHARMACY

WILBARGER COUNTY, TX

4,843,750

40

REPUBLIC DRUG STORE

FERRY COUNTY, WA

2,681,690

40

KERMIT PHARMACY

WINKLER COUNTY, TX

1,356,350

39

DYER DRUG CO

CLINTON COUNTY, KY

1,181,230

39

WHITWELL PHARMACY

SEQUATCHIE COUNTY, TN

4,856,320

39

BLAND COUNTY PHARMACY

BLAND COUNTY, VA

2,390,300

39

GENE LAFITTE PHARMACY

JOHNSTON COUNTY, OK

3,766,890

39

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 2014.

For 2006 through 2014, 15 percent

of pharmacies ...

1,000 pharmacies

... received 50 percent of pain pills

100,000,000 pills

Source: Washington Post analysis of Drug

Enforcement Administration data

For 2006 through 2014, 15 percent

of pharmacies ...

1,000 pharmacies

... received 50 percent of pain pills

100,000,000 pills

Source: Washington Post analysis of Drug Enforcement

Administration data

For 2006 through 2014, 15 percent of pharmacies ...

1,000 pharmacies

... received 50 percent of pain pills

100,000,000

pills

Source: Washington Post analysis of Drug Enforcement

Administration data

For 2006 through 2014, 15 percent of pharmacies ...

1,000 pharmacies

... received 50 percent of pain pills

100,000,000

pills

Source: Washington Post analysis of Drug Enforcement

Administration data

Other findings include:

Newly disclosed federal drug data shows that more than 100 billion doses of oxycodone and hydrocodone were shipped nationwide from 2006 through 2014 — 24 billion more doses of the highly addictive pain pills than previously known to the public.

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.

• At the height of the opioid epidemic, Walgreens handled nearly one out of every five oxycodone and hydrocodone pills shipped to pharmacies across America. Walgreens dominated the nation’s retail opioid market from 2006 through 2012, buying about 13 billion pills — 3 billion more than CVS, its closest competitor.

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 2014.

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 2010-2014 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 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. Nearly 90,000 pharmacies were geocoded by The Post using Google's Maps API after cleaning addresses registered in the ARCOS database. The Post manually geocoded more than 4,000 pharmacies.

The business names of each pharmacy come directly from the DEA database as of 2014 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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