Over the course of the last three decades, the opioid epidemic has cut a wide swath through American society, from the rural heartland to the largest cities, from suburban middle America to urban neighborhoods. Tens of thousands of Americans have died each year for more than 20 years from overdosing on the highly addictive synthetic painkillers pharmaceutical companies peddled as groundbreaking and non-addictive when, in fact, they were as addictive as cocaine or heroin.

Preliminary data released last week by the federal Centers for Disease Control and Prevention in Atlanta showed that for the first time since the epidemic began in the 1990s, drug overdose deaths decreased from one year to the next declined. According to data, there were 68,000 overdose deaths in 2018, a 5 percent drop from the 70,000 or so reported in 2017. While any decrease in the yearly body count in this decades-long epidemic is to be welcomed, the CDC warns that it’s too early to draw any conclusions from its 2018 data. First, the numbers are preliminary and subject to revision. Second, the death toll may simply have plateaued for one year only after an especially deadly 2017. There’s no reason, the agency says, to believe we’re at the beginning of the end of the epidemic.

The CDC report coincided with the Drug Enforcement Administration opening its massive database on opioid distribution to the public. Spanning the years 2006 to 2012, the DEA tracks every, single pain pill manufactured and sold in the United States. In those years, there were 380 million transactions processed for prescription pain killers, with a staggering 76 billion pills pumped out. Deaths specifically caused by opioid overdoses during this seven-year period numbered more than 100,000 — by way of comparison, slightly more than 58,000 American troops died between 1955 and 1973 in the Vietnam war.

Another statistic for comparison’s sake is the death toll on the nation’s highways. The National Highway Transportation Safety Administration recorded an estimated 40,000 fatalities in highway crashes in 2018, a slight 1 percent drop from 2017’s 40,231. Keep in mind, drug overdose deaths in the same year amounted to 68,000.

So how did these little pills of addiction and death make their way into virtually all reaches of American society? The just-opened DEA database and documents revealed in the discovery phases of several high-profile civil trials against the drug industry shed light on the pipeline from Big Pharma’s production lines to the neighborhood pharmacy, with a friendly prescriber in the middle. And the picture the data paints is stunning.

The Washington Post has created an online portal that’s searchable by state and locality that’s filled with statistics on the epidemic; it can be accessed at https://wapo.st/2Lw9Euy. When searching it, a disturbing picture of how this public health crisis grew emerges.

For example, two Virginia cities had the highest per-capita distribution rates of opioids in the nation between 2006 and 2012. Norton, a small city in Far Southwest Virginia, had the highest per-capita distribution rate of 306 pills per person during this time period, with Martinsville in Southside Virginia — a city of just over 13,000 residents — a close second with 242 pills per person.

Statewide, the database reveals 1,596,911,249 pills prescribed in Virginia during this time period with Cardinal Health being responsible for the distribution of more than 329 million pills.

Drill down into the numbers to the local level, and the picture becomes even more staggering:

» Lynchburg: Almost 27.5 million pills distributed with CVS, Cardinal Health and Walgreens responsible for nearly 19 million.

» Amherst County: 5.6 million pills with CVS, Walmart and Cardinal Health responsible for more than 5.3 million.

» Bedford County: Nearly 8.3 million pills with CVS, Walmart and Cardinal Health distributing more than 5.3 million pills.

» Campbell County: 5.9 million pills with CVS, N.C. Mutual Wholesale Drug and Cardinal Health responsible for distributing more than 4.6 million pills.

» Appomattox County: 4.4 million pills with AmerisourceBergen Drug and CVS distributing nearly 3 million between them.

» Nelson County: More than 2.4 million pills distributed with the largest distributor — AmerisourceBergen Drug — responsible for 1.6 million pills.

The scope of the epidemic is simply mind boggling. Billions of dollars have been spent at all levels of government over the last couple of decades to combat the opioid epidemic: health care dollars, law enforcement dollars, social service dollars. Tens of thousands of people have died from opioid overdoses. As various lawsuits against the drug industry, including one brought by 49 state attorneys general, advance, this public health crisis and its ramifications will be with us for decades to come.

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