Enough opiate-based drugs flowed legally into Lexington County over a seven-year period to supply every person in the county with 32.4 potentially addictive pills per year, according to newly-disclosed records from the federal Drug Enforcement Administration (DEA).
From 2006 to 2012, 57 million opioid pills were shipped into this one county, according to a DEA database that tracks the nation’s pharmaceutical supply chain. The DEA recorded more than 380 million transactions nationally and traced the path of every opiate-based pill delivered from drug manufacturers and distributors to pharmacies across America.
Locally, CVS Pharmacy received the ninth-highest number of opioid pills among all Lexington County retailers, taking in 4,018 shipments totaling 1.65 million pills. The Walmart Pharmacy accepted 4,461 shipments totaling 954,320 pills, while the Walgreens location received 1,067 shipments totaling 298,100 opioid pills.
Among all Lexington County drug retailers, PruittHealth Pharmacy Services in Lexington topped the DEA list, bringing in more than 4,500 shipments totaling 2.9 million opioid pills over seven years.
Although shipped legally by pharmaceutical companies to fill prescriptions written by doctors and other healthcare professionals, millions of opioids are abused daily by prescription-holders or illegally diverted for sale on the black market. Epidemic misuse of opioids has contributed to what President Donald Trump (R) declared in 2017 a national “public health emergency.”
More than 140 Americans die every day from opioid overdose, according to the Centers for Disease Control and Prevention in Atlanta. Opioids accounted for more than 47,600 overdose deaths nationwide in 2017.
At least 76 billion opioid pills were shipped across the country by drug manufacturers during the seven-year period covered by the DEA’s declassified records.
County-by-county data for every state in the U.S. was released last week following a year-long legal battle waged by The Washington Post and HD Media, a newspaper group in West Virginia, one of the states where opioid abuse is epidemic. The DEA was compelled by a federal court in Ohio to reveal its complete manufacturer, distributor and retailer database.
The Washington Post’s publication of the DEA numbers included only shipments of oxycodone and hydrocodone. The newspaper’s analysis did not factor in 10 other opioids because “they were shipped in much lower quantities and were diverted at far lower rates over the seven years,” The Post stated in sharing the DEA records with other news outlets across the nation, including The Twin-City News.
Not just a ‘big box’ issue
In response to the DEA release, CVS Inc. told The Washington Post that they “dispensed over 4.2 billion retail prescriptions during that time period [2006-2012], and opioid medications were a very small percentage of that total. Pharmacies dispense medication, including controlled substances, to patients who have authorized prescriptions written by doctors, physicians and other prescribers.”
Walgreen Co. responded to the The Post data analysis by saying, “Walgreens pharmacists are highly trained professionals committed to dispensing legitimate prescriptions that meet the needs of our patients… Walgreens has been an industry leader in combating this crisis in the communities where our pharmacists live and work.”
Walmart Inc. did not offer a comment to The Post.
Although large retail chains received most of the legally-shipped opioids, independent drugstores also were listed in the DEA data. Among local retailers, three smaller pharmacies – Capsules Inc. (Apothecare Pharmacy), Owen Drug Company (now Morgan’s Pharmacy in the Batesburg district) and Morgan’s Pharmacy in Gilbert – each received shipments of at least a half-million opiate-based pain pills over the seven years recorded in the DEA report.
Almost half of the pills that ultimately arrived in Lexington County were manufactured by SpecGx LLC, a Missouri-based division of British pharmaceuticals giant Mallinckrodt. More than 24.4 million SpecGx-made pills were sold to stores countywide.
On the list of distributors shipping into this county, Ohio-based Cardinal Health led the influx, dispensing 11.1 million opioid pills to area retailers. Walgreen Co. delivered 9.1 million opioids into Lexington County, followed closely by the 8.7 million opioids shipped by CVS Health Corp. to its stores here.
South Carolina: Making progress?
As prescription opioid abuse has gained more national attention, officials in South Carolina have tackled the problem both as a public health crisis and a law enforcement challenge.
In December 2017, Governor Henry McMaster (R) established an Opioid Emergency Response Team, led jointly by the South Carolina Law Enforcement Division (SLED) and the state Department of Alcohol and Other Drug Abuse Services. More than two dozen organizations and state agencies have collaborated on a four-pronged strategy to battle the opioid crisis: educate and communicate, prevent and respond, treat and recover, and coordinated law enforcement
A report released by the South Carolina Department of Health and Environmental Control (DHEC) in October 2018 stated that “the number of opioids in South Carolina peaked in 2015 but has been decreasing since.” According to DHEC, more than 311 million opioid pills were dispensed in the Palmetto State during 2016, but that number dropped to 286 million pills statewide by 2017.
In its report, DHEC officials said that “public messaging… has raised awareness about the problem in South Carolina” and federal mandates and insurance guidelines, among other factors, “have had a positive impact on opioid dispensing patterns in our state.”
Still, despite reductions in the number of pills distributed, opioid-related deaths in South Carolina increased by 13.3 percent in a single year from 2016 to 2017, according to the CDC. Last August, DHEC reported the number of opioid overdose deaths jumped 47 percent from 2014 to 2017.
In 2017 alone, DHEC tracked 249,374 opiate-based prescriptions dispensed in Lexington County. That same year statewide, more than 5 million prescriptions were written for Schedule II narcotics, the DEA classification for drugs designated as “dangerous” and “with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”
In Lexington County alone, 36 deaths and 330 overdose hospitalizations in 2017 were attributed to opioids.
“Absolutely, it’s a problem. There’s way too many prescription narcotics being prescribed to people, opioids in particular,” said Lieutenant Robby Lint, who heads the Lexington County Sheriff’s Department narcotics unit. He cited one example of a root canal patient who might be prescribed a 30-day supply of opiate-based painkillers for two or three days of post-surgery discomfort.
“I know manufacturers have pushed these narcotics out there to pharmacies and doctors because it’s a money-making business,” Lt. Lint said. “But there’s nothing wrong with [patients] telling them, ‘I don’t want that many pills. Give me less.’”
Fentanyl: Dangerous to both abusers & EMS
Among the opioid-related deaths in Lexington County during 2017, at least 14 were attributed to the potent and addictive synthetic opioid fentanyl. Most often prescribed to cancer patients for pain management, fentanyl can be 50 times more potent than heroin and up to 100 times more powerful than morphine, according to the CDC.
Fentanyl gained general public awareness after being tied to the deaths of musicians Prince, Mac Miller and Tom Petty.
It may be administered by tablet, injection, skin patches, lozenges or nasal spray, among other methods. The variety of delivery methods makes fentanyl particularly prone to illegal misuse and abuse.
The ongoing opioid crisis has forced law enforcement and emergency medical personnel across the country – and here in Lexington County – to take special care against the potential dangers not only to drug users but to first responders. In 2016, the DEA cautioned cops against field-testing drugs seized in raids if fentanyl is suspected.
“Submit the material directly to the laboratory for analysis and clearly indicate on the submission paperwork that the item is suspected of containing fentanyl,” the DEA said in a release to police agencies. “This will alert laboratory personnel to take the necessary safety precautions during the handling, processing, analysis, and storage of the evidence.”
The DEA further warned that “officers should be aware that while unadulterated fentanyl may resemble cocaine or heroin powder, it can be mixed with other substances which can alter its appearance.”
Because of that warning, Lexington County has adopted a policy of not field-testing any of the drugs its deputies encounter. “We glove-up, we take every safety precaution, we bag it and we turn it in as evidence to make sure it gets tested by a chemist in a safe environment,” Lt. Lint said.
Lexington County deputies and police officers in Batesburg-Leesville now are trained to carry a nasal spray called Narcan®, designed to block the harmful effects of opioids. Earlier this month, Batesburg-Leesville Town Council approved an agreement with DHEC to accept Narcan® anti-opioid spray to be used by the Town’s fire department first responders.
“We’re always giving our officers materials and training on how to deal with this issue,” said Batesburg-Leesville Police Chief Wallace Oswald. “We train the guys that even touching that stuff can be dangerous.”
Elsewhere in the Midlands
Overall, the Midlands fared somewhat better in the DEA’s opioid distribution reports than other regions of South Carolina.
In Richland County, which includes the Columbia urban center, the six-year data showed an average of about 22 prescription opioid pills per person per year shipped to pharmacies. Aiken County retailers received an annual average of 35 pills per person, while Saluda County drugstores received an average of 13 pills per person.
The DEA’s records revealed a far higher number of prescription opioids shipped into the tourist-heavy Grand Strand and Lowcountry, where Charleston County pharmacies shipped in a staggering 248 pills per person per year from 2006-2012.
Still, as state officials say they are slowly winning the war on opioid abuse, Lexington County law officers remain committed to their role in the ongoing fight.
“First and foremost, this is not something we’re going to be able to arrest our way out of,” said Lt. Lint, the county’s lead drug warrior. “Yes, we go out and do a lot of narcotics investigations, and we arrest a lot of people. But a lot of it has to come down to education. People need to understand what this is and how it affects you.”
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For more educational resources on the opioid crisis in South Carolina, visit the Department of Alcohol and Drug Abuse Services at www.daodas.sc.gov.
Story by Tony Baughman / Posted on August 1, 2019