One hundred ninety-one: Opioid manufacturers and distributors sold that many pills in bulk in Vermont for every man, woman and child during the seven-year period that ended in 2012.
The total tally of oxycodone and hydrocodone pills sold at wholesale in the Green Mountains during that period was a whopping 119,480,773.
The figures come from a database released this week by the U.S. Drug Enforcement Administration detailing itemized purchases of prescription opioids in the U.S. from 2006 through 2012. The dataset offers an unprecedented window into the pharmaceutical industry’s business dealings as the opioid crisis grew.
Oxycodone and hydrocodone purchases peaked in 2011 at 18.2 million pills. That same year, Vermont medical providers wrote 502,566 prescriptions for opioids in a state with a population of just under 627,000.
Manufacturers and distributors are required to report transactions involving controlled substances to the DEA. The agency released the dataset, which contains hundreds of millions of opioid transactions, as a result of a lawsuit filed by the Washington Post and the Charleston Gazette-Mail in West Virginia.
On Thursday, the Post published the raw data detailing oxycodone and hydrocodone sales from 380 million transactions. The Post did not include data on 10 other prescribed opioids that were distributed in far smaller amounts and were less likely to be diverted.
The data shed light on the closely guarded prescription opioid market during a critical point in the opioid crisis. Oxycontin and other prescription opioids surpassed illicit heroin as the primary source of opioid addiction for those receiving drug abuse treatment in 2006, according to the Vermont Department of Health.
Nationally, the number of opioid prescriptions peaked in 2012, when doctors wrote 81.3 prescriptions for every 100 U.S. residents.
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The database does not reveal sales to end users, however. So though it tracks the flow of prescription opioids into Vermont, not every pill was necessarily distributed to a consumer.
The largest Vermont-based purchaser, according to the database, was HealthDirect Institutional Pharmacy, which provides pharmacy services to correctional and elder care facilities, as well as other institutions. HealthDirect bought 3.9 million pills over that seven-year period — more than 3.1 million of those in May 2008, according to the federal data. The company is owned by KPH Healthcare Services, which also owns Kinney Drugs.
The company is a large institutional purchaser with offices in eight states, so the drugs it purchased may not have stayed within Vermont. Because it’s not a pharmacy, doctor’s office or retailer, Seven Days excluded that data from our analysis.
The top distributor of opioid pills into the state between 2006 and 2012 was McKesson. The San Francisco-based pharmaceutical distributor sold just over 40 million pills to Vermont-based buyers during that time — nearly twice as many pills as the next largest distributor, Cardinal Health.
The top manufacturer of those pills was SpecGx, a subsidiary of U.K. pharma giant Mallinckrodt, which manufactured nearly 49 million of the pills Vermont-based companies purchased. Though Purdue Pharma has garnered many of the headlines — and lawsuits — over its role in the opioid crisis, it supplied just 5.1 percent of the oxycodone and hydrocodone pills tallied in the database.
Between 2006 and 2012, the University of Vermont Medical Center’s Burlington location purchased the highest number of opioid pills, at 3.4 million. (Its Colchester outpatient location purchased an additional 1.1 million pills.)
At the county level, Windham pharmacies and medical facilities stocked 35.6 opioid pills per person each year between 2006 and 2012, for a total of 11.1 million pills. Franklin, Bennington, Lamoille, Washington and Chittenden counties also came in above the statewide average of 27.3 pills per person per year.
On the low end, Grand Isle businesses stocked 7.9 pills per person, while Essex businesses stocked 1.6. That doesn’t mean people in those counties weren’t receiving and filling prescriptions, though. The residents of those lightly populated areas likely headed to pharmacies and doctor’s offices in other counties.
In fact, the only businesses ordering opioid prescription drugs in Essex County during that time were the Island Pond Health Center and a veterinary clinic. Here’s a look at how Vermont’s counties compared:
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The reason for the low number in Essex is simply because there are no pharmacies here, and only one health care facility, a small community clinic in Concord, VT. People here go to Weeks Medical Center and Indian Stream Medical, across the river in NH. Talk to our Essex Co Sheriff Trevor Colby, and he will tell you the opiate crisis is huge here.
And naysayers wonder how the problem became epic? Proof is in the pudding.
Where was The Medical Community in Vermont ? No one in the medical community notice the pill mills
in Florida also ?
WHEN will all of you begin to hold the DEA and MDS accountable for this epidemic of decades? Top of the food chain does not know what they are doing?? Are you an ostrich with your head in the sand??
The AMA, the doctors Union, has religiously defended a doctors right to do anything they want ! The DEA remains hidden in its role! I watched patients for ten years be over prescribed controlled substances and then seek help when they were shut down. Young folks received Felony convictions for pills obtained from Addict MDs that the state Board of Registration of Medicine did Mothing about! Some folks died, many experienced addiction. I spoke up in my role and had my career destroyed.
Loss of decent work opportunities, poverty, educational gaps, & the worse things humans do to each other lead to addiction. And, many rich folks making critical decisions are heavy cocaine & alcohol users . It is the USA- get on your knees! It is a doctor or a dollar bill!!
This reminds me of the early 1970s, when the oversight authorities found out that 60% of tranquilizers and stimulants were disappearing from wholesalers, and never even reaching the legal market.
Yes, this is a problem – BUT from what I’ve seen, the oversight people are hassling doctors and patients alike now, so we can’t blame the people (patients) themselves. I don’t know anyone who knows a pill-pusher doctor. Perhaps someone has noticed that the Baby Boomer generation is huge, and that they’re all trying to stay young with sports and such, and many have chronic pain issues? This affects statistics.
This also ignores the totally illegal and illegally-dispensed Fentanyl, which is now the cause of Most ODs. I hope this leads to some real arrests – and results in less trouble for those who need the drugs as Medicine – people who are Not addicted – just in pain. “Pills per capita” indeed! Foo.
PS – the doctors have been gathered into giant “Community Health and Good Health systems” which makes it look like UVM is handing stuff out – they have 1000 doctors!
Three of the top four pharmacies in the list are the Kinney Drug retail stores in St Albans, Morrisville, and Barre, which “bought” from the distributors over 2.5 MILLION pills over a six year period. Individual pharmacies in small towns. Pushed that many pills out their front doors. What did they think they were doing? What did they think was going on? They had to know. They were reporting it to DEA, but doing nothing to stop it.
Why aren’t they accountable? If you shop at either of those pharmacies, ask the pharmacist what the hell they thought was going on?
Heard a commentator the other day point out that this is just legalized drug pushing. None of the people involved will be spending any time in jail, compared to all the folks locked up for selling or possessing small amounts of pot.
Am I missing something here? I believe what we have here is a simple supply and demand model. Albeit, a dysfunctional one. Opoid addiction is big business in Vermont, particularly UVM’s medical center, rehab sites, non-profits to help addicts, etc. Last I knew, doctors write the prescriptions and pharmacists fill them. Are commenters saying pharmacists should be reporting certain doctors who are prescribing too many pills? Refusing to fill prescriptions to make a dent in the opoid crisis? I simply don’t understand the outrage at pharmacies. The outrage is misdirected anger. The doctors deserve your wrath.
Only in America would we deliberately foster a deadly epidemic among ourselves so that a few on the top could make a pile of money. Only in America.
Why blame the drugs they have been around a long time and were certainly much easier to get in the 1970’s. It is the social environment that has changed and people feel hopeless without any hope for a happy future. In VT nothing but minimum wage jobs and taxes and the cost of living is insane. While the politicians chase green energy and a utopian socialist future, the average Vermonter is struggling to just survive.
But lets blame it all on the drugs.
I hope the entire Sackler family goes to prison. And not “country club” prison, the real kind. Maybe they’ll get to meet some of the people they affected with their incredible greed and lack of human decency.
Ive seen lots of press about the role of pharmaceutical makers, their distributors and pharmacies in what caused the opioid crisis including Andreas recent article presenting lots of distribution metrics.
As far as I know, opioids are prescription controlled. I have not seen that any of the millions of pills manufactured were stolen and/or sold on the black market by their makers or distributors. My conclusion is that these millions of pills were prescribed by doctors.
I haven’t seen a deep dive into what the role of hospitals and individual doctors has been. Where are the stats of which VT hospitals and doctors prescribed opioids? What are the stats by hospital and doctor?
“Three of the top four pharmacies in the list are the Kinney Drug retail stores in St Albans, Morrisville, and Barre, which “bought” from the distributors over 2.5 MILLION pills over a six year period. Individual pharmacies in small towns. Pushed that many pills out their front doors. What did they think they were doing? What did they think was going on? They had to know. They were reporting it to DEA, but doing nothing to stop it.”
When I worked in assisted living, Kinney drug managed the facility’s medications. The vast majority of the residents got their meds from Kinney, including people who had just had surgery, people with severe chronic pain and people on hospice. When a lot of people with chronic pain (like elderly people) are concentrated in one place, you see certain patterns in prescribing.
Anyone who thinks opioids are being handed out “like candy” hasn’t tried to fill an opioid prescription lately. The pendulum has swung back to denying opioids to people with cancer, people who have just had surgery, people on hospice, and people in sickle-cell crisis (on top of the medical establishment discounting pain in black patients).
“Only in America would we deliberately foster a deadly epidemic among ourselves so that a few on the top could make a pile of money. Only in America.”
It has happened before, with Iran-Contra and the feds allowing urban areas to be flooded with cocaine and heroin. However, those addicts were brown, so their addiction was a crime, not a disease.