Since 2016, The Washington Post has been investigating the opioid epidemic that has ravaged communities and claimed the lives of more than 200,000 people nationwide since 1996.
On July 15, a previously unreleased Drug Enforcement Administration database that tracks the path of every single pain pill sold in the United States — from manufacturers and distributors to pharmacies in every town and city — was made public. It was disclosed as part of a civil action brought by nearly 2,000 cities, towns and counties alleging nearly two dozen drug companies conspired to saturate the nation with opioids. The database is a virtual road map to the epidemic.
The Post’s analysis found:
• America’s largest drug companies distributed 76 billion oxycodone and hydrocodone pain pills across the country between 2006 and 2012 as the nation’s deadliest drug epidemic spun out of control. Just six companies distributed 75 percent of the pills during this period.
• The volume of the pills handled by the companies climbed as the epidemic surged, increasing 51 percent from 8.4 billion in 2006 to 12.6 billion in 2012. The states that received the highest concentrations of pills per person per year were: West Virginia, Kentucky and South Carolina.
• 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 experienced more than three times that rate on average.
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Over the past three years, The Post’s reporting has led to revelations about those in charge of the tightly regulated prescription supply chain — the manufacturers, distributors, pharmacies, doctors and the DEA itself.
The reporting revealed behind-the-scenes lobbying to weaken the DEA’s attempts to halt the flow of the drugs and exposed how companies in the supply chain, even after they were warned about suspicious shipments, continued to flood communities with pain pills.
In early 2016, The Post began investigating how hundreds of millions of highly addictive pain pills that are sent along a tightly regulated pharmaceutical supply chain were fueling a growing, deadly epidemic.
• Starting in 2006, the DEA launched an aggressive campaign to curb the rising opioid epidemic, targeting companies that distributed pills and the corrupt pharmacies and pill mills that illegally diverted the drugs to the black market. But the industry fought back.
• Thirteen drug distributors should have known that hundreds of millions of pills were ending up on the black market, according to court records, DEA documents and legal settlements in administrative cases reviewed by The Post. Even when the companies were alerted to suspicious pain clinics or pharmacies, some distributors continued to send drugs.
• Pharmaceutical companies have hired dozens of officials from the top levels of the DEA during the past decade. The hires came after the DEA launched an aggressive campaign to curb the rising opioid epidemic.
In 2017, reporters dug deeper into the issue, working with “60 Minutes” to explore in greater depth the pressure that had been exerted on Congress by the drug industry and its lobbyists and its impact on some key DEA investigations into large drug companies.
• At the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the DEA of its most potent weapon against large drug companies. The law was the crowning achievement of a multifaceted campaign by the drug industry to weaken DEA enforcement efforts.
• After two years of painstaking investigation, a DEA team was ready to move on the biggest opioid distribution case in U.S. history. Instead, top attorneys at the DEA and the Justice Department struck a deal that was far more lenient than the field agents wanted, according to interviews and internal government documents.
• In 2012, distributor Cardinal Health got word that the DEA was about to take action against a Florida warehouse that supplied millions of painkillers every month. Cardinal retained Washington lawyer Jamie Gorelick, who had served as deputy U.S. attorney general from 1994 to 1997. She reached out to her old agency on the company’s behalf, and the impact was immediate.
2018 and 2019
In 2018 and 2019, The Post turned its focus to the synthetic painkiller fentanyl, the latest wave of the opioid crisis, which claimed the lives of about 30,000 that year. Pain pill addiction had given rise to heroin use, which in turn created a soaring demand for fentanyl, which is 50 times as powerful as heroin.
• Federal officials failed to grasp how quickly fentanyl was creating another — and far more fatal — wave of the epidemic. In the span of a few years, fentanyl became the drug scourge of our time. If current trends continue, the annual death toll from fentanyl will soon approach the yearly toll from guns or traffic accidents.
• The depth of the fentanyl problem continues to overwhelm the government’s response, and the administration has yet to produce a comprehensive strategy that is legally required by Congress. Health policy experts say treatment funding is not nearly enough.