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The manufacturers and distributors of opioid prescription painkillers have supplied billions of pills throughout the U.S. An investigative series by The Washington Post looks at the opioid epidemic through the DEA's newly public database that tracks every pain pill sold to pharmacies across the country. Steven Rich, The Post's data editor, joins Hari Sreenivasan with more.
The manufacturers and distributors of opioid prescription painkillers supplied billions of pills throughout the country, and it led to addiction, abuse and death. You can see how and where the epidemic grew in a new Washington Post report, part of the investigative series The Opioid Files. Using a newly public Drug Enforcement Administration database that tracks every pain pill sold to pharmacies across the country, reporters analyzed millions of transactions and shipments of oxycodone and hydrocodone pills from 2006 to 2012.
I recently spoke with Steven Rich, data editor for The Washington Post, about how the newspaper's team got the database and what they found.
So we wound up intervening in a court case in Ohio in which this data became an exhibit in order to try to force its release. We did so with the Charleston Gazette Mail in West Virginia. And over the course of the last year we managed to fight an appeal and make it public. And what we learned was that there are way more pills flowing into the pharmacies across the country than we had expected. There were 76 billion pills over the seven-year timeframe all over the country. But the pills themselves weren't equally distributed. There were far more pills per person in places like Appalachia in West Virginia and Kentucky.
And you can go on the site and basically plug it in by county, on a county-by-county level and see. And one of the breakdowns that you have, what's really fascinating is you kind of divide it by the population there. So you say how many pills per person actually showed up and the numbers on some of these counties are staggering.
Yeah. So across the country the national average was 36 pills per person per year. But some of these counties especially in south West Virginia have upwards of 200 pills per person per year. And this is not just for people who are prescribed the pills. This is 200 for every man, woman and child living in that county.
And in this, you're also uncovering emails and part of the reporting and part of the opioid file story, and what is the culture that's happening at the companies that are distributing this down to the pharmacy level instead of saying, hey wait, that seems like a really large number — What were the conversations?
So I think one email sort of sums it up pretty well for me, which is one sales manager emailed and just said, "Sell, sell, sell," The culture was you know the people who sold the most of these drugs into these pharmacies were the ones who were getting the biggest bonuses and there was a lot of, in many of these emails there was a callous nature around the addiction aspect of this. And so really what we're starting to see for the first time is how these companies handled these unusual shipments to these pharmacies. For example, in one case we found a Purdue Pharma executive who got a suspicious order emailed to him and one minute later he approved it. And so they are required to report these suspicious orders to the DEA. And so that's why they had the system in the first place, but if somebody is approving things that quickly it's hard to tell whether they're actually trying to figure out if the order is suspicious or they're just approving everything.
So depending on the case some of these companies say listen it wasn't our fault that we're not responsible. Even given all these emails that we're talking about. But what is the consequence, what is the repercussion, what can Congress do?
It's hard to say. I mean we are sort of past the heart of the prescription pill crisis and into the fetanyl crisis. So trying to stop this wave of opioids is sort of where they need to be. Right now, the current solution to that is using sort of these overdose reversing drugs like Narcan and that is sort of stemming the problem a little bit in places like Ohio. But it's just sort of a Band-Aid of a solution. And so there really needs to be sort of an emphasis on stopping fentanyl from getting into the country and also in treatment for people who are addicted to it.
You know even though we've seen some slight improvement in the numbers we're still talking 60,000 plus people dying every year as part of this crisis. So when I wonder — that your numbers went to 2012, right, I mean you think that the problem is worse or did it get worse in those last three or four years that we don't have the data for yet.
So we think that it probably got a little worse in 2013 and 2014 and around that time is when the DEA really started to crack down on prescription pills. And so we think that it probably started to get a little better in 2015 and 2016. But around that same time, people were starting who were addicted to these and unable to get the pills anymore started to switch to heroin. And as a result of that they ended up getting hooked and then eventually many of them switched over to fentanyl. And that's sort of how we've ended up where we are today.
Yeah. And finally what is the kind of revolving door in government about this? I mean especially considering that this is a DEA database that you found all this through, what's happening to some of those employees now?
So we know that a lot of the DEA employees who worked specifically in the division to prevent diversion of these drugs to the black market are now working at many of these drug companies in their diversion departments. And so they're literally sitting across the table from where they used to sit. Where they were trying to stop it, now they're trying to convince the DEA that these companies are doing well with stopping it. And so we've seen dozens of employees in recent years make the jump directly from the DEA to these drug companies for much more lucrative jobs.
All right. Steven Rich, data editor of The Washington Post, thanks so much.
Thank you for having me.
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