According to newly released information from the Drug Enforcement Administration, almost 7 million prescription pain pills were shipped to Monroe County over a seven-year period.
That comes from a newly public DEA database The Washington Post recently gained access to after a year-long legal battle.
The database, called the Automation of Reports and Consolidated Orders System, tracks where every painkiller in the country is manufactured and distributed, down to individual pharmacies.
The available data covers 2006-2012, when the opioid epidemic gained significant momentum, and includes information on the two most popular pain pills: hydrocodone and oxycodone.
Over that time period, 76 billion of those pills were in the country, with Illinois having about 1.9 billion of them.
Monroe County, which had a population of just under 33,000 as of the 2010 census, was home to 6,998,810 of those pills.
That is enough for roughly 30 pills per person per year in the county.
“It doesn’t surprise me, just given the approach that a lot of the pharmaceutical companies take,” Monroe County Sheriff Neal Rohlfing said of those numbers. “It’s one of the most aggressive businesses out there.”
While experts debate the role having so many painkillers in the country played in the opioid crisis, some have argued it contributed to rising levels of addiction and overdose deaths.
That interpretation often factors in a massive lawsuit in Ohio that alleges several large drug companies continued shipping drugs despite signs they were being sold illegally and diverted to the black market.
According to the Centers for Disease Control in Prevention, overdose deaths in the U.S. increased each year from 2006 to 2012. They reached 70,237 in 2017.
The total did drop for the first time in years in 2018, however, to 68,557.
Many of those deaths are not from overdosing on prescription medication, but that could still have been a factor because many opioid addicts start with those pills, including in Monroe County.
“The majority of people that we have arrested for heroin have said they started with prescription pills until they become too costly,” Rohlfing said.
Rohlfing said the price of high-potency oxycodone and oxycontin is $80-$100 on the black market, whereas a button of heroin, which is the smallest size, costs about $10.
Monroe County Coalition for Drug-Free Communities chairman Gary Most said his group has also seen that phenomenon occur.
“We’ve seen from conversation with folks who have come to be members or be affiliated with the coalition that they have had family members become addicted to painkillers,” he noted.
A Waterloo woman who identified herself only as Anne was one of those people who became addicted for several years following a surgery.
While she never took illegal opioids, Anne said she could see how people would do that.
“There’s not a day that I don’t think about the high,” Anne said. “I was out in a no-man’s land kind of place. But I’m in a better place now.”
During the seven years on record, more than 5 million of those pills that made their way to Monroe County were manufactured by Actavis Pharma, Inc. or SpecGx LLC.
Those pills went to a number of locations, but the biggest distributors were Walgreens and Walmart, which distributed about 2.7 million pills and 1.3 million pills, respectively.
Locally, the pharmacies that had the most pills shipped to them were Waterloo Walgreens with about 1.4 million, Walmart with about 1.4 million, Columbia Walgreens with 1.3 million and Wightman Pharmacy with 894,810.
While those numbers may seem shocking, it is important to note all those pills did not necessarily go to people in the county because data only shows what pharmacies the pills were shipped to.
Many companies responsible for most of the nation’s pills in those seven years have pushed back against the idea that they operated improperly.
“Walgreens’ pharmacists are highly trained professionals committed to dispensing legitimate prescriptions that meet the needs of our patients,” that company told The Post. “Walgreens has not distributed prescription controlled substances since 2014 and before that time only distributed to our chain of pharmacies. Walgreens has been an industry leader in combatting this crisis in the communities where our pharmacists live and work.”
Actavis Pharma, which was bought by a company called Teva in 2016, went a step further.
“Teva has not conspired, failed to report suspicious orders or contributed to the abuse of opioids in the U.S. in any way,” it said. “We maintain a comprehensive and robust system to prevent suspicious orders from ever entering the market.”
Local officials were more hesitant to absolve the companies of any wrongdoing.
“It definitely plays somewhat of a role,” Rohlfing said of how the abundance of pills impacts local drug problems. “I wouldn’t call it an epidemic yet in Monroe County, but when you hear 7 million pills prescribed, where in the world are those going?… It definitely leads to problems and causes problems that we’ve seen.”
“That sheer number would certainly have some type of impact,” Most agreed.
For Most, Rohlfing and Anne, this new data only underscores the importance of properly disposing of unwanted or expired prescription medication.
Residents can do so during prescription drug take-back days the coalition hosts twice each year or at drop boxes at the police departments in Waterloo and Columbia and at the sheriff’s department with no questions asked.