DEA information shows flood of drugs sent to N.H.

FILE - In this Aug. 29, 2018, file photo, oxycodone pills are displayed in New York. Newly released federal data shows how drugmakers and distributors increased shipments of opioid painkillers across the U.S. as the nation’s addiction crisis accelerated from 2006 to 2012. (AP Photo/Mark Lennihan, File)

NASHUA – Shipments of a drug intended to help people stop using heroin, fentanyl and other opioids – but which can, itself, be abused – to New Hampshire increased nearly 10-fold from 2007 to 2017.

This is but one statistic uncovered by The Telegraph in reviewing previously withheld Drug Enforcement Administration data. The DEA released the information this week after a federal judge ordered it be made public.

“This data confirms that the pharmaceutical industry created a tsunami of opiates that drove addiction and death rates up,” Dr. Thomas Frieden, former head of the Centers for Disease Control and Prevention, said.

The information shows that shipments of buprenorphine to New Hampshire went from 3,515 grams in 2007 to 32,093 grams in 2017.

Buprenorphine is the main ingredient in the commonly used opioid treatment drug Suboxone. Just last week, the company that formerly manufactured Suboxone agreed to pay a record $1.4 billion fine to the U.S. Department of Justice to settle claims involving the marketing of the drug.

Records also show that 76 billion oxycodone and hydrocodone pills – the vast majority of them generics, not brand names – were shipped to U.S. pharmacies from 2006 to 2012.

The annual number swelled by more than 50 percent over that period of time even as the body count climbed. The powerful painkillers flowed faster even after Purdue Pharma was fined $635 million for falsely marketing OxyContin as less addictive than other opioids.

Prescription and illegal opioids such as heroin and fentanyl have been factors in more than 430,000 deaths in the U.S. since 2000, according to the Centers for Disease Control and Prevention. From 2006 to 2012, annual opioid deaths rose from under 18,000 a year to more than 23,000. During that time, prescription drugs were cited as factors in just under half the deaths.

Since then, overall opioid deaths in the U.S. have doubled, though on Wednesday the CDC reported that drug overdose deaths of all kinds probably fell last year for the first time in nearly three decades.

The newly released information shows in the detail the flow of drugs from manufacturers to communities.

West Virginia, Kentucky, Tennessee and Nevada all received more than 50 pills for every man, woman and child each year. Several areas in the Appalachian region were shipped an average of well over 100 pills per person per year.

The figures are from the DEA’s Automation of Reports and Consolidated Orders System, or ARCOS. Below is a list showing the number of grams of buprenorphine, fentanyl and oxycodone shipped to New Hampshire by year, according to ARCOS:

2007

Buprenorphine – 3,515

Fentanyl – 2,172

Oxycodone – 264,235

2009

Buprenorphine – 9,579

Fentanyl – 2,504

Oxycodone – 337,201

2011

Buprenorphine – 13,875

Fentanyl – 2,495

Oxycodone – 356,584

2013

Buprenorphine – 18,688

Fentanyl – 2,365

Oxycodone – 357,000

2015

Buprenorphine – 25,149

Fentanyl – 2,074

Oxycodone – 342,191

2017

Buprenorphine – 32,093

Fentanyl – 1,391

Oxycodone – 249,381

Nearly every state, including New Hampshire, has filed a lawsuit, and most of them have focused on Purdue and members of the Sackler family, who own the Stamford, Connecticut-based company and are major philanthropists whose donations to museums and universities have now come under scrutiny. Many local governments have also sued other drugmakers, distribution companies and pharmacies.

The lawsuits say that with the introduction of OxyContin, a time-released opioid, in 1995, Purdue created a new playbook to push the use of opioids for more patients and in higher doses.

But Purdue points out, accurately, that the company produced only a small fraction of the nation’s opioids – about 3% between 2006 and 2012, according to the data. Three companies – SpecGX, Par Pharmaceutical and Activis Pharma – that sold lower-priced generic drugs, including versions of OxyContin, combined to make 90% of the pills.

The three companies say that they didn’t market the drugs and were just meeting the demand of prescriptions filled out by doctors – and that they didn’t produce more than the DEA allowed.

Perry Rowthron, a former Connecticut deputy attorney general, said those factors could make it hard to blame those generic manufacturers.

“It’s always been the view that branded manufacturers created the demand that is now being met by generics,” he said.

As for the distributors, they contend they functioned as a delivery service and keep federal authorities apprised of the quantities of drugs being shipped.

Four companies – McKesson Corp., Walgreens, Cardinal Health and AmerisourceBergen – each distributed more than 10% of the opioids sent to pharmacies. McKesson distributed more than 18% of the nation’s opioids from 2006 to 2012 – the most of any company – but said it didn’t push sales.

“Any suggestion that McKesson influenced the volume of opioids prescribed or consumed in this country would reflect a misunderstanding of our role as a distributor,” a spokeswoman said via email.

Dr. Joshua Sharfstein of Johns Hopkins University said the lack of transparency around the prescribing data probably slowed the federal response to the opioid epidemic.

“To a certain extent, no agency really felt responsible and had access to the data in real-time to see what was happening,” he said.

DEA officials declined to comment on the litigation, but said the agency is working to ensure patients have access to the medications they need, while also policing excessive drug shipments.

Elizabeth Burch, a law professor at the University of Georgia, called the release a “game-changer” in the legal cases.

“Making it public shows the vast disparity between say, Mingo County, West Virginia (with 203.5 pills per person per year) and Hooker County, Nebraska (with 0 pills per person per year),” she said in an email.

She said the information could help the hardest-hit places get a bigger piece of any settlement reached.

Yale law professor Abbe Gluck said the drug distribution details are already being used by the parties negotiating settlements, so their impact could be minimal there.

“On the other hand,” she said in an email, “releasing the data feeds the public’s hunger for knowledge and accountability and so may put additional pressure on the defendant companies.”