Prescription opioid shipments declined sharply even as fatal overdoses increased, new data shows

Prescription opioid shipments declined sharply even as fatal overdoses increased, new data shows

The number of prescription opioid pills shipped in the U.S. in the second half of the 2010s decreased sharply even as a nationwide overdose crisis continued to deepen, according to data released Tuesday.

The decline in painkiller prescriptions — finally dropping below the quantities sold in the mid-2000s when the overdose epidemic accelerated — happened after state and federal governments tightened prescribing guidelines and state, local and Native American tribal governments sued the industry over the toll of the addictive drugs.

“We are still at an epidemic proportion of pills,” Peter Mougey, a lawyer representing governments that are suing drugmakers, distribution companies and pharmacies, said in an online news conference to release the data Tuesday.

The distribution data is being released by lawyers after a judge ordered the U.S. Drug Enforcement Administration to share it with the plaintiffs. The governments assert that the companies should have done more to stop the flow of opioids when they saw that more than necessary were flowing to pharmacies and patients.

The lawyers obtained the updated data from the DEA’s Automation of Reports and Consolidated Orders System, or ARCOS, as part of their lawsuits. It showed that in 2019, 8.8 billion dosage units — pills, patches, lollipops — were shipped for 12 common opioids. That’s just over half as many doses as the peak of shipments in 2010, when nearly 16 billion doses were moved.

Lawyers also noted that the strongest doses of pills from before are no longer on the market.

But Mougey pointed out that as prescription drug shipments decreased, illicit opioids — particularly heroin and illegally produced versions of fentanyl — increased. And the number of deadly overdoses continued to climb.

The first public release of data four years ago was more dramatic, showing how the prescribing and shipping of powerful prescription opioid painkillers increased through the late 2000s and early 2010s. During that time, prescription drugs were the opioids linked to the most deaths in the U.S.

The data showed how doctors were prescribing more powerful pills, even as the deaths added up. And it showed just how pervasive the drugs were: Each year, drug companies were shipping enough pills for everyone living in some counties — mostly in Appalachia — to have more than a 100-day supply.

The newly released data is the first deep look at what happened with prescription drug shipments later in the 2010s. But the story of the overdose crisis from that time forward is well documented and dire.

By the early 2010s, policymakers and doctors were restricting access to prescription opioids. People who had become addicted looked for other sources and found them in illicit pills, which are often counterfeit, and other street drugs. Heroin deaths increased dramatically, and so did those from illicit and potent synthetic opioids such as fentanyl, which are often added to other drugs by dealers.

The fentanyl-driven crisis is more deadly than any other drug tragedy the nation has ever seen. In 2010, opioids were linked to just over 21,000 deaths in the U.S. In 2022, the opioid-related death toll was more than 82,000.

Cleveland-based U.S. District Judge Dan Polster, who is overseeing evidence in all the lawsuits in federal courts, previously required that the data from 2006 through 2014 be shared. The Washington Post and HD Media, a company that owns newspapers in West Virginia, went to court to seek the information, which was released publicly beginning in 2019.

The lawsuits are now in a very different place. Some have gone to trial, with mixed results. But most of the key companies have reached settlement agreements that will total more than $50 billion if they’re all finalized. That includes up to $6 billion from members of the Sackler family, who own OxyContin maker Purdue Pharma. That settlement is on hold while the U.S. Supreme Court reviews it.

Just last week, the Kroger Co., a supermarket chain that operates in 35 states, agreed to pay up to $1.4 billion in settlements.

Most of the settlement funds are required to be used to combat the opioid epidemic.

In his July ruling ordering that more recent data be shared, Polster remarked that making the earlier tranche public “was both wise and monumental” because it helped lead to the settlements. “It is fair to say none of this would have been possible without production of the ARCOS data,” Polster wrote.


4 Responses

  1. If they didn’t have the ability to be totally and utterly disingenuous, they wouldn’t have much at all.

  2. I work for big pharm drug plan. Right now so many meds are in short supply because manufactures can’t start manufacturing them till the next quarter. We now have Dr calling in and asking if XYZ is available and what doses are not available. They ask what other meds their plans will pay for. Sadly the dem are not going after all the illegals and cartel that are bringing in massive amounts of drugs from Columbia, Haiti, Dominic Republic, Mexico to be sold on the streets. 94.8% of the people who die from over doses are bought in illegally and sold on the streets. DEA, CDC and States need to go after the ones who are dealing drugs instead of going after Doctors who do pay attention to the laws and prescribe accordingly. I am so angry at our Gov.

    • Yes, it boggles the mind as to why more people aren’t asking why they’re still so laser focused on doctors, in addition to every link in the chain leading to patients receiving a prescription, when they could -and should- be directing that focus on the phenomenal disaster at hand that is illicitly manufactured fentanyl and nitazenes on the streets of every community in this country. All of that effort, money, manpower, and attention should be reserved for the burgeoning threat. One would think, anyhow, if they ever hope to actually save anyone instead of just clamping down on those in pain. Even if they wish to persist with their erroneous belief that Rx opioids are THE culprit for addiction in America, it should be abundantly clear by now that Public Enemy #1 doesn’t come from Big Pharma, or have anything to do with manufacturing, distribution, sale, prescription, or legitimate utilization of Rx opioids for treatment of pain. But here they are, still “plugging all of the holes” where one might accidentally be allowed to fill legally prescribed pain meds. It’s sailed far beyond the point of being justifiable. In fact, it’s effectively one of the most heinous things I have ever witnessed in my lifetime, on domestic soil. A sentiment I will stand by until the day I am released from my broken, dysfunctional body, or the day that the insanity stops cold.

      • Alpha Wolf, I will stand by you in sentiment.

        Why don’t they track down illicit drugs pill by pill backwards, to where they came from? Just like they track where every single one of my pill has traveled to? They track it so intently that I’m tested to see if it is in my urine! Invasive and the testing has been shown to be of no help to doctors in their treatment of patients.

        And the DEA had best NOT cut back on opioids. We’ve had enough cutbacks to where legitimate patients with legitimate prescriptions are unable to get them filled. DEA – STFU and stay out of medicine. You are NOT DOCTORS. The DEA caused the cut backs and even the numbers put out by both the CDC and DEA CLEARLY show that RX opioids have NEVER been the cause of the so called “Opioid Crisis”. Shakes my head in utter disgust.

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