Want To Know Where The Opioid Epidemic Hit Colorado Hardest? Follow Where The Pills Went

July 18, 2019

New federal data tracking opioid pills, published by The Washington Post, highlights areas of Colorado hit hardest by the opioid crisis.

The newspaper obtained Drug Enforcement Administration data to track every pill distributed in the country from 2006 to 2012. In Colorado, drug companies distributed the highest number of pills per person in southern parts of the state where the epidemic has hit hardest.

Alamosa County saw 88 pills distributed per person between 2006 and 2012. More than 68 pills per person per year were distributed in Pueblo County, 67 pills per person per year in Otero and 50 pills per person per year in Huerfano.

Those counties have sued drug companies alleging they used fraudulent tactics to addict patients. The companies deny that.

For comparison, the analysis found drug companies distributed 67 and 63 annual pills per person respectively in West Virginia and Kentucky. South Carolina, Tennessee, Nevada, Oklahoma, Alabama and Oregon all saw figures above 50 pills per person annually.

The Colorado data correlates with other information about the impact of the opioid epidemic, according to Robert Valuck, who heads the Colorado Consortium for Prescription Drug Abuse Prevention.

While the drugs have legitimate uses for many pain patients, Valuck said, “Wherever they (opioids) go the data are clear, problems go along with them. Everything from misuse and non-medical use to addiction or use disorders, overdoses, treatment admissions and deaths."

Pueblo and nearby southern Colorado counties have been disproportionately affected by the opioid epidemic, according to a report by the Colorado Health Institute. It found the drug death rates due to opioids — prescription drugs and heroin — in Huerfano, Las Animas and Pueblo counties were double the state rate, or more, between 2014-16. 

Companies distributed 19 pills per person per year in Denver County. Prescription drugs were distributed in higher numbers in other Front Range communities. The data show drugs were distributed at levels above 25 pills per person per year in Adams, Arapahoe, and Boulder counties. Mesa County on the Western Slope saw an even higher number: 38 pills per person a year between 2006 and 2012.

The Washington Post describes that data as a “virtual road map” of the opioid epidemic. It found the drug companies sold staggering numbers of pills nationally. The top five opioid manufacturers sold more than 70 billion pills over that seven-year period. Those include SpecGx, Actavis Pharma, Par Pharmaceutical, Purdue Pharma and Amneal Pharmaceuticals. The first three of those companies accounted for 88 percent of the opioids manufactured.

Six companies, McKesson Corp., Walgreens, Cardinal Health, AmerisourceBergen, CVS and Walmart, distributed 75 percent of the pills, according to The Post’s analysis of the database.

The release of the data came after a long legal battle by news outlets to get the information.

It comes as U.S. District Judge Dan Polster in Ohio is overseeing a consolidated case of nearly 2,000 lawsuits, including those a number of Colorado cities and counties. Polster removed a protective order for part of the database, which lead to its release.

The state of Colorado is not part of the consolidated case in Ohio. It has a separate case against Purdue Pharma and individual members of Sackler family (which founded and owns Purdue) and former executives of the company. 

The new data appears to bolster claims made in lawsuits against opioid distributors and manufacturers.

For example, last year, a group of southern Colorado counties sued some of the nation’s biggest makers of opioids.

Conejos, Las Animas, Chaffee, Otero and Alamosa counties and the city of Alamosa sued companies including Purdue Pharma, Johnson & Johnson, Cephalon Inc., Teva Pharmaceuticals, Janssen Pharmaceuticals, Endo Pharmaceuticals and Mallinckrodt LLC.

They alleged the number of opioid prescriptions in their jurisdictions topped the number of residents and led to deaths, overdoses and problems like domestic violence and child abuse.

According to the suit, nearly 21,000 opioid prescriptions were dispensed in 2015 in Alamosa County, which has a population of more than 16,600. In Otero County, which has around 18,000 residents, more than 30,000 opioid prescriptions were filled for that same year. Chaffee County saw more than 26,000 opioid prescriptions dispensed that year for a population of about 19,000.

"We issue more prescriptions per capita than anywhere else in the state as an example, or most other places in the state. And we're one of the small counties," Keith Goodwin, an Otero County Commissioner, told CPR News last year. "Are we sicker than everybody else? I don't think so." 

The suit said “scientific evidence demonstrates a close link between opioid prescriptions and opioid abuse.” It cited a study, which found a “very strong correlation” between exposure to opioids “measured by prescriptions filled” and their abuse, with “particularly compelling data” for extended-release oxycodone, also called Oxycontin.

The drug manufacturers have vigorously denied wrongdoing, arguing the drugs were federally approved.

Distributors said the data in The Washington Post analysis wouldn’t exist had they not accurately reported sales. They pointed a finger at the government for its role in the crisis.

“The DEA has been the only entity to have all of this data at their fingertips, and it could have used the information to consistently monitor the supply of opioids and when appropriate, proactively identify bad actors,” said John Parker, Senior Vice President of Communications of the Healthcare Distribution Alliance, in a statement. “Unlike the DEA, distributors have no authority to stop physicians from writing prescriptions, nor can they take unilateral action to halt pharmacies’ ability to dispense medication.”