The map shows the loci of the opiod epidemic. It is concentrated in the Applachian region, Las Vegas and northern California. A recent government study, suppressed by the DEA but released after a lawsuit, shows that pharmaceutical companies continued to flood vulnerable communities with pills even after it was known that the powerful and highly addictive pain killers were hitting the streets. The DEA's ARCOS database tracks the movement of every prescription pill from factory to pharmacy. A retired DEA official says now a consultant to plaintiffs bringing suit against drug makers, "We’re seeing a lot of internal stuff that basically confirms what we already knew. It just reinforces the fact that it was all about greed, and all about money.” The industry lays the blame for abuse of their product on doctors, and the DEA which its says has the authority to ban the overuse of prescription medications.
Six companies distributed 75% of the opiods hydrocodone and oxycodone and just three companies manufactured 88% of them. The industry shipped 76 billion pills during 2006-2012, spiking at 12.6 billion. The industry is supposed to self-regulate, but plaintiffs claim that sales personnel were given key roles in compliance issues. Bonuses for sales of opiods could reach six figures. Public ire at the role of pharmaceutical companies in the epidemic has previously centered on Purdue Pharma which released it's OxyCotin brand of oxycodone in 1996. That drug was marketed as a less addictive form of pain killer because the slow release formulation did produce a high. Experts trace the beginning of the epidemic to the drug's release and migration into illegal drug trafficking. But the new data shows that the problem is industry wide and not just one company. Purdue's sales represent only 3% of the market. Major distributors are household names: Walgreens, CVA and Walmart.
Prescription opioid overdoses have claimed the lives of more than 200,000 people in the United States since 1996. There is a legitimate need for powerful pain-killers, since some unfortunates suffer from chronic, severe pain and nothing else will give them relief. The fact is these pharmaceuticals are chemically related to street heroin, and have the same addictive properties. Deaths from fentanyl, the powerful synthetic opioid that is being illicitly manufactured abroad and smuggled into the United States, continue to increase.
The accountability question is now being played out in the courtroom. A federal judge in Cleveland is presiding over 2,000 cases filed by counties against drug companies for the costs of dealing with the abuse epidemic. Two test cases are set to begin this fall. The DEA issued compliance letters in 2005, 2006 warning companies to work harder to prevent their pills from reaching the black market. The warnings went unheeded as the illicit supply continued to grow. A few successful regulatory enforcement cases were brought, but the fines were trivial compared to the profits being made. In one example, McKesson, a distributor, was fined a record $150 million in 2017. That year the company's net income was $5 billion. God bless the almighty dollar.