Data: Metro Detroit pharmacies received more than 40 percent of state's pain pill supplies

Susan Vela
Hometown Life
The City of Wayne has joined several other communities in potential lawsuits against opioid manufacturers.

At least 40 percent of the 2.9 billion prescription pain pills supplied to Michigan in the years preceding the nation’s third wave of opioid overdose deaths landed in Oakland, Wayne and Macomb counties, according to federal data released over the summer.

The flood of pills fueled opioid deaths across the region, and some experts are thankful the newly-released Drug Enforcement Administration database can now be used to pinpoint trends and problem areas.

“It’s a great tool,” said Linda Davis, executive director of Families Against Narcotics in Macomb County. “The data is very helpful in seeing where we stand as a state.”

The Washington Post and HD Media, which publishes the Charleston Gazette-Mail in West Virginia, took legal action to get the once-secret database released.

The Post went through nearly 380 million transactions from 2006 through 2012 that are detailed in the DEA’s database and analyzed shipments of oxycodone and hydrocodone pills

Post analyzers said oxycodone and hydrocodone pills make up three-quarters of the total opioid pill shipments to pharmacies.

Numbers for metro Detroit counties gave proof to the region’s problem, which seems to be most intense in Wayne County.

According to the database, there were 2,852,578,277 prescription pain pills supplied to Michigan from 2006 through 2012 and Wayne County received at least 618 million. Oakland County received 308.5 million and Macomb County received about 285.4 million for that same time period.

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McKesson Corporation in Irving, Texas, was Michigan’s main distributor, doling out 514 million pills for the years reviewed.

Spokeswoman Sunny Rodriguez emailed this statement: “McKesson distributes prescription opioids and other medications in response to orders placed by state-licensed and DEA-registered pharmacies, and those pharmacies may only dispense these medications to patients with a valid prescription written by a government-licensed health care provider.

“As the … data demonstrates, McKesson has consistently disclosed controlled substance transactions to the DEA. For decades, DEA has had exclusive access to this data, which can identify the total volumes of controlled substances being ordered, pharmacy-by-pharmacy, across the country.

“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.”

Actavis Pharma Inc. in New Jersey was the main manufacturer providing opioids to Michigan. Omnicare of Southern Michigan in Livonia was the pharmaceutical enterprise receiving the most pills — 16,758,390 — in the state. 

CVS Health spokesman Mike DeAngelis explained that CVS Health acquired Omnicare in 2015. Omnicare provides long-term care pharmacy services to clients like nursing homes and assisted-living facilities.

“Omnicare pharmacies generally only fill prescriptions for these large institutional clients that provide regular, on-site medical care to patients,” he wrote in an email. “An Omnicare pharmacy typically has a larger scale of business than a retail pharmacy due to the number of patients being served by its clients.

“During the 2006-2012 time period in question, LTC pharmacies primarily served skilled nursing facilities, which routinely admit patients discharged from hospitals after being treated for fractures, hip and joint replacements or traumatic injury. When these conditions require opioid analgesic therapy, a professional nurse determines that an opioid is necessary to treat pain, pursuant to a physician’s prescription for the opioid.”

The Post’s database gives data on top distributors, manufacturers and pharmaceutical recipients for Michigan’s counties, along with per-person availability for local counties. Wayne County received enough for 46 pills per person per year from 2006 to 2012. Oakland County received enough for 36 pills per person and Macomb County received enough for 48 pills per person.

Davis advised caution when reviewing the data.

“People don’t necessarily develop pain just because of where they live,” she said.

Victoria Tutag Lehr, a Wayne State University pharmacy practice professor, said the database is good for verifying some suspected trends.

“It has some research helpfulness, (yet) you just can’t assume that all those doses dispensed went to a patient with a prescription,” Lehr said. “People will tell you they’re not afraid of going to jail, losing their house, waking up in an alley … They are afraid of going into withdrawal. It’s a big, big issue.”

She would prefer a more zoomed look at prescription opioid pills, such as similar data for census tracts or zip codes.

Lehr emphasized that opioids should be part of “multi-modal management” that includes other treatments like topical anesthetics and physical therapy.

The Michigan Department of Health and Human Services reports that 115 people overdosed of drugs involving opioids in Michigan in 1999, compared to 2,053 in 2017. Wayne County’s drug overdoses involving opioids went from 46 to 636 for those same years, compared to 12 to 55 in Oakland County and 4 to 320 in Macomb County.

According to the National Institute on Drug Abuse, between 21 and 29 percent of patients prescribed opioids for chronic pain misuse them and about 80 percent of heroin users first misused prescription opioids.

The U.S. economic burden from prescription opioid misuse was calculated to be $78.5 billion in 2013 because of healthcare, lost productivity, addiction treatment, and criminal justice involvement.2

Scientists with the Centers for Disease Control and Prevention said the year 2013 marked the start of the nation’s third wave of opioid overdose deaths, which showed significant increases in overdose deaths involving synthetic opioids like the illicitly-manufactured fentanyl.  

Contact Susan Vela at svela@hometownlife.com or 248-303-8432. Follow her on Twitter @susanvela