There were more pain pills in Pulaski County per person from 2006 through 2012 than either the state or national averages, according to recently released data from the federal DEA (Drug Enforcement Administration).
In that time frame, there were a total of 29,044,240 prescription pain pills supplied locally — enough for 67 doses for every Pulaski County adult and child per year. That's compared to 63.3 doses for every Kentuckian (1,901,662,933 pills) and 36 doses for every person in the United States (76 billion pills).
Laura Woodrum, Director of Nursing at the 10-county Lake Cumberland District Health Department, called the number of prescriptions filled in the time frame "staggering."
"The opioid epidemic began with prescription pills, spawned increased heroin use and then resulted in the current fentanyl crisis, which added more than 67,000 to the death toll from 2013 to 2017 across the United States," Woodrum said. "Substance abuse — more specifically, opioid misuse — is crippling rural communities by affecting quality of live, economic opportunity, and rural prosperity."
In analyzing the data, TheWashington Post found as a general rule that rural counties, especially in Appalachia, received some of the highest shares of pain pills per person — fueling the prescription opioid epidemic that caused nearly 100,000 deaths during those years.
Pulaski County Attorney Martin Hatfield talked about how this particular issue has gone from a need to treat individual addiction to a nationwide crisis.
"The addiction to opioids has led to an extraordinary number of deaths due to overdose, broken families and broken homes, has overburdened our law enforcement community and criminal justice system to nearly a breaking point, and cost our local governments (taxpayers) millions of dollars," Hatfield said. "In my 30-plus years as a prosecutor, I have never witnessed such a crisis!"
The DEA database tracks every regulated pain medication in the U.S. Drug manufacturers, distributors and pharmacies must log and report each narcotic transaction.
Kentucky ranked second in the states receiving the highest concentrations of pills per person per year, behind West Virginia with 66.5. They were followed by South Carolina (58), Tennessee (57.7) and Nevada (54.7).
Nearly half the pills were distributed nationwide by three companies: McKesson, Walgreens and Cardinal Health. For Pulaski County, the numbers were as follows: Cardinal Health, 6.5 million; AmerisourceBergen, 4.6 million; Smith Drug Company, 3.8 million; Walgreen Co., 3.5 million; and McKesson Corporation, 2.8 million.
Healthcare Distribution Alliance (HDA) Senior Vice President of Communications John Parker released the following statement on the release of the Drug Enforcement Administration’s (DEA) Automation of Reports and Consolidated Orders System (ARCOS) data:
“The ARCOS data show that distributors have consistently reported sales of opioid-based medications, along with the quantity of the order and the identity of the receiving pharmacy to the DEA. Distributors only recently received access to the full set of data with information about the total shipment of opioid medicines a particular pharmacy received from all distributors.
“The DEA has been the only entity to have all of this data at their fingertips, and it could have used the information to consistently monitor the supply of opioids and when appropriate, proactively identify bad actors. Unlike the DEA, distributors have no authority to stop physicians from writing prescriptions, nor can they take unilateral action to halt pharmacies’ ability to dispense medication.”
The top manufacturer nationwide was Mallinckrodt's SpecGx with nearly 38 percent of the market. For Pulaski County, the top five manufacturers were: Actavis Pharma Inc., 15.9 million; SpecGx LLC, 7.8 million; Par Pharmaceutical, 3.1 million; Amneal Pharmaceuticals LLC, 556,900; and Purdue Pharma LP, 516,020.
The five local pharmacies receiving the highest number of pills between 2006 and 2012 are all based in Somerset: Medicine Shoppe, Walgreen Co., West Somerset Pharmacy Inc., Professional Pharmacy of Somerset, and Wal-Mart Pharmacy.
Pulaski County is among some 2,000 communities, counties and Indian tribes which have filed federal lawsuits against pharmaceutical distributors and/or manufacturers accused of contributing to the opioid epidemic by failing to report suspicious orders in order to maximize profits. The lawsuits have been consolidated into one case in the US District Court for the Northern District of Ohio under Judge Dan Polster.
In discussing the case, Pulaski County Judge-Executive Steve Kelley noted that the numbers aren't just statistics.
"This issue is so difficult for me because I know so many personally who are addicted," Judge Kelley said. "The statistics actually have names. They are our children, our brothers and sisters, our parents. It hurts to think about the lives that have been ruined, and to pray it doesn't happen to my family and my friends' families. But I know drugs are life stealers, and they don't care whose lives they steal. It is a cancer that eats away at our productivity and livelihood. It is a dark cloud that hangs over the victims and their loved ones. It is a clear and present danger that we need to eliminate. If only I could make the issue go away, I would."