For the first time, a database maintained by the Drug Enforcement Administration that tracks the path of every single pain pill sold in the United States — by manufacturers and distributors to pharmacies in every town and city — has been made public.
The Washington Post sifted through nearly 500 million transactions from 2006 through 2014 that are detailed in the DEA’s database and analyzed shipments of oxycodone and hydrocodone pills, which account for three-quarters of the total opioid pill shipments to pharmacies. The Post is making this data available at the county and state levels in order to help the public understand the impact of years of prescription pill shipments on their communities.
These records provide an unprecedented look at the surge of legal pain pills that fueled the prescription opioid epidemic, which resulted in nearly 130,000 deaths during the nine-year time frame ending in 2014.
A county-level analysis of the cumulative data shows where the most oxycodone and hydrocodone pills were distributed across the country over that time: more than 100 billion in all.
Number of pills distributed per person, per year
Average yearly total, by county, 2006 through 2014
Use two fingers to pan around the map.Pinch to zoom.
Tap a district to see details
The Post gained access to the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System, known as ARCOS, as the result of a court order. The Post and HD Media, which publishes the Charleston Gazette-Mail in West Virginia, waged a year-long legal battle for access to the database, which the government and the drug industry had sought to keep secret.
The version of the database published by The Post allows readers to learn how much hydrocodone and oxycodone went to individual states and counties, and which companies and distributors were responsible.
Find the data for where you live
Visit this page on a desktop computer to download the data.
Visit this page on a desktop computer to download the data.
Visit this page on a desktop computer to download the data.
The Post believes this is a critically important set of data, which is why we are making it public and accessible to readers and other journalists. We think there are hundreds of stories within this data set and need your help to understand what it means to you and your community. Want to use this data or our findings in your own work? Click here to find out how.
There were no prescription pain pill transactions for this county in the data.
The Post analysis shows that the volumes of the pills handled by the companies climbed as the epidemic surged, increasing 52 percent from 8.4 billion in 2006 to 12.8 billion in 2011. Pill distribution started to decline slightly in 2012, and the additional data shows that, by 2014, the number of pills distributed was 11.8 billion. Yearly county-level maps show how the influx of pills spread.
Just six companies distributed 76 percent of the pills — oxycodone and hydrocodone — during this period: McKesson Corp., Walgreens, Cardinal Health, AmerisourceBergen, CVS and Walmart, according to an analysis of the database by The Washington Post.
Top pill distributors, 2006 through 2014
Click on a column to sort the table.
| Distributor | Percent of market | |
|---|---|---|
|
McKesson Corp. |
19 billion pills |
18.9% |
|
Cardinal Health |
15 billion pills |
14.7% |
|
Walgreens |
15 billion pills |
14.5% |
|
AmerisourceBergen |
13 billion pills |
13.2% |
|
CVS |
7.7 billion pills |
7.6% |
|
Walmart |
7.1 billion pills |
7.1% |
|
Smith Drug Co. |
1.7 billion pills |
1.7% |
|
Rite Aid |
1.6 billion pills |
1.6% |
|
Kroger |
1.6 billion pills |
1.6% |
|
H. D. Smith |
1.4 billion pills |
1.4% |
|
Anda, Inc |
1.3 billion pills |
1.3% |
|
Morris & Dickson Co |
1.2 billion pills |
1.2% |
|
Kaiser Permanente |
1.1 billion pills |
1.1% |
|
Thrifty Payless Inc |
1.1 billion pills |
1.1% |
|
Omnicare Distribution Center LLC |
940 million pills |
0.9% |
|
Eckerd Corporation |
900 million pills |
0.9% |
|
N C Mutual Wholesale Drug Co |
780 million pills |
0.8% |
|
Smith's Food & Drug Ctr's Inc |
660 million pills |
0.7% |
|
Kinray Inc |
630 million pills |
0.6% |
|
The Harvard Drug Group |
440 million pills |
0.4% |
|
Advantage Logistics |
440 million pills |
0.4% |
|
Value Drug Co |
430 million pills |
0.4% |
|
Publix Super Markets, Inc. |
370 million pills |
0.4% |
|
Associated Pharmacies Inc |
370 million pills |
0.4% |
|
HEB Grocery Company, LP |
340 million pills |
0.3% |
|
Valley Wholesale Drug Co |
280 million pills |
0.3% |
|
River City Pharma |
280 million pills |
0.3% |
|
SAJ Distributors |
270 million pills |
0.3% |
|
Longs Drug Store |
270 million pills |
0.3% |
|
Harco |
260 million pills |
0.3% |
|
Louisiana Wholesale Drug Co |
250 million pills |
0.3% |
|
Albertsons LLC |
230 million pills |
0.2% |
|
Frank W Kerr Inc |
210 million pills |
0.2% |
|
Top Rx, Inc. |
200 million pills |
0.2% |
|
Qualitest Pharmaceuticals |
180 million pills |
0.2% |
|
American Sales Company |
170 million pills |
0.2% |
|
KeySource Medical |
160 million pills |
0.2% |
|
Rochester Drug Co-Operative Inc |
160 million pills |
0.2% |
|
Miami-Luken |
160 million pills |
0.2% |
|
Hy-Vee |
160 million pills |
0.2% |
|
Quest Pharmaceuticals Inc |
150 million pills |
0.1% |
|
American Drug Stores |
150 million pills |
0.1% |
|
Meijer Distribution Inc #90 |
150 million pills |
0.1% |
|
Pharmacy Buying Association |
150 million pills |
0.1% |
|
HBC Service Company |
150 million pills |
0.1% |
|
Dakota Drug |
120 million pills |
0.1% |
|
Par Pharmaceutical, Inc. |
120 million pills |
0.1% |
|
Auburn Pharmaceutical |
110 million pills |
0.1% |
|
Mc Queary Brothers |
100 million pills |
0.1% |
|
Winn Dixie Logistics |
100 million pills |
0.1% |
|
KPH Healthcare Services, Inc. |
91 million pills |
0.1% |
|
Aphena Pharma Solutions |
89 million pills |
0.1% |
|
Dik Drug Co |
83 million pills |
0.1% |
|
Wakefern Food Corporation |
72 million pills |
0.1% |
|
Discount Drug Mart |
69 million pills |
0.1% |
|
Prescription Supply Inc |
67 million pills |
0.1% |
|
Sunrise Wholesale, Inc |
66 million pills |
0.1% |
|
P J C Distributor Co Inc |
65 million pills |
0.1% |
|
Bryant Ranch Prepack |
61 million pills |
0.1% |
|
Schnucks Pharmacy Distribution Ctr |
59 million pills |
0.1% |
|
Burlington Drug Company |
58 million pills |
0.1% |
|
Southwood Pharmaceuticals Inc |
57 million pills |
0.1% |
|
Dispensing Solutions |
57 million pills |
0.1% |
|
Bloodworth Wholesale Drugs |
56 million pills |
0.1% |
|
Thrifty White Warehouse |
55 million pills |
0.1% |
|
Drogueria Betances |
48 million pills |
0.1% |
|
Murfreesboro Pharmaceutical |
47 million pills |
0.1% |
|
NuCare Pharmaceuticals |
46 million pills |
0.1% |
|
Mallinckrodt LLC |
43 million pills |
0.0% |
|
Henry Schein Inc |
40 million pills |
0.0% |
|
DRx Pharmaceutical Consultants, Inc. |
40 million pills |
0.0% |
|
Actavis Pharma |
39 million pills |
0.0% |
|
Bellco Drug Corp |
39 million pills |
0.0% |
|
Expert-Med |
35 million pills |
0.0% |
|
Cedardale Distributors LLC, DBA Gen-Source RX |
34 million pills |
0.0% |
|
PD-Rx Pharmaceuticals Inc |
33 million pills |
0.0% |
|
Richie Pharmacal |
32 million pills |
0.0% |
|
Heartland Repack Services |
32 million pills |
0.0% |
|
GCP Pharma LLC |
29 million pills |
0.0% |
|
Lake Erie Medical |
28 million pills |
0.0% |
|
D & K Healthcare Resources |
26 million pills |
0.0% |
|
White Drug 61 |
26 million pills |
0.0% |
|
Altura Pharmaceuticals, Inc |
26 million pills |
0.0% |
|
Stat Rx USA LLC |
24 million pills |
0.0% |
|
Amneal Pharmaceuticals |
22 million pills |
0.0% |
|
Aidarex Pharmaceuticals LLC |
22 million pills |
0.0% |
|
Dixon-Shane LLC |
22 million pills |
0.0% |
|
Paragon Enterprises Inc |
22 million pills |
0.0% |
|
Dohmen Distribution Partners |
22 million pills |
0.0% |
|
Allscripts, LLC |
20 million pills |
0.0% |
|
QK Healthcare, Inc. |
20 million pills |
0.0% |
|
Medsource Pharmaceuticals |
18 million pills |
0.0% |
|
King Drug Company of Florence |
18 million pills |
0.0% |
|
Genetco Inc |
17 million pills |
0.0% |
|
H J Harkins Company Inc |
17 million pills |
0.0% |
|
JM Blanco Inc |
16 million pills |
0.0% |
|
Moore Medical LLC |
14 million pills |
0.0% |
|
DIT Healthcare Distributio |
14 million pills |
0.0% |
|
Price Chopper Operating Co Inc |
14 million pills |
0.0% |
|
Duane Reade |
13 million pills |
0.0% |
Three companies manufactured about 85 percent of the opioids: SpecGx, a subsidiary of Mallinckrodt; Actavis Pharma; and Par Pharmaceutical, a subsidiary of Endo Pharmaceuticals.
Top pill manufacturers, 2006 through 2014
Click on a column to sort the table.
| Labeler | Percent of market | |
|---|---|---|
|
SpecGx |
36 billion pills |
35.7% |
|
Actavis Pharma |
32 billion pills |
32.0% |
|
Par Pharmaceutical |
18 billion pills |
17.6% |
|
Amneal Pharmaceuticals |
4.0 billion pills |
4.0% |
|
Purdue Pharma |
3.2 billion pills |
3.2% |
|
KVK Tech |
1.7 billion pills |
1.7% |
|
Teva Pharmaceuticals USA |
720 million pills |
0.7% |
|
Sun Pharmaceutical Industries, Inc. |
710 million pills |
0.7% |
|
Kaiser Foundation Hospitals |
480 million pills |
0.5% |
|
West-Ward Pharmaceuticals |
470 million pills |
0.5% |
|
Alvogen, Inc. |
370 million pills |
0.4% |
|
AbbVie Inc. |
370 million pills |
0.4% |
|
Endo Pharmaceuticals |
330 million pills |
0.3% |
|
Ethex Corporation |
290 million pills |
0.3% |
|
Mylan Pharmaceuticals, Inc. |
270 million pills |
0.3% |
|
Zydus Pharmaceuticals (USA) Inc. |
190 million pills |
0.2% |
|
UCB, Inc. |
190 million pills |
0.2% |
|
McKesson Corp. |
160 million pills |
0.2% |
|
Aurolife Pharma LLC |
150 million pills |
0.1% |
|
Golden State Medical Supply, Inc. |
130 million pills |
0.1% |
|
Cardinal Health |
120 million pills |
0.1% |
|
Dispensing Solutions Inc. |
100 million pills |
0.1% |
|
Aphena Pharma Solutions - Tennessee, LLC |
92 million pills |
0.1% |
|
Bryant Ranch Prepack |
62 million pills |
0.1% |
|
Xanodyne Pharmaceuticals, Inc. |
56 million pills |
0.1% |
Comparing county-level maps of opioid overdose deaths and pill shipments reveal a virtual opioid belt of more than 90 counties stretching southwest from Webster County, W.Va., through southern Virginia and ending in Monroe County, Ky. This swath includes 18 of the top 20 counties ranked by per-capita prescription opioid deaths nationwide and 12 of the top 20 counties for opioid pills distributed per capita.
Number of pills per person per year
Average county yearly total 2006 through 2014
5
75
150+
Opioid Deaths
Cumulative opioid death rate 2006 through 2014
0
15
30+
per 100,000
people
Source: Data compiled by the DEA and CDC and
analyzed by The Post
Number of pills per person per year
Average county yearly total 2006 through 2014
5
75
150+
Opioid Deaths
Cumulative opioid death rate 2006 through 2014
0
15
30+
per 100,000
people
Source: Data compiled by the DEA and CDC and
analyzed by The Post
Number of pills per person per year
Opioid Deaths
Average county yearly total 2006 through 2014
Cumulative opioid death rate 2006 through 2014
5
75
150+
0
15
30+
per 100,000
people
Source: Data compiled by the DEA and CDC and analyzed by The Post
Number of pills per person per year
Opioid Deaths
Average county yearly total 2006 through 2014
Cumulative opioid death rate 2006 through 2014
5
75
150+
0
15
30+
per 100,000
people
Source: Data compiled by the DEA and CDC and analyzed by The Post
Number of pills per person per year
Opioid Deaths
Average county yearly total 2006 through 2014
Cumulative opioid death rate 2006 through 2014
5
75
150+
0
15
30+
per 100,000
people
Source: Data compiled by the DEA and CDC and analyzed by The Post
About this story
The Washington Post analyzed data from the Drug Enforcement Administration's Automation of Reports and Consolidated Orders System, known as ARCOS, from 2006 to 2014.
Data analyzed includes only shipments from sales of oxycodone and hydrocodone pills to retail pharmacies, chain pharmacies and practitioners. The entire database tracks a dozen different opioids, including oxycodone and hydrocodone, which make up three-quarters of the total pill shipments to pharmacies.
Originally published July 16, 2019.
Data analysis by Steven Rich, Aaron Williams and Andrew Ba Tran. Graphics, design and development by Armand Emamdjomeh, Kevin Schaul, Jake Crump and Chris Alcantara. Editing by Danielle Rindler, Tim Meko and Matt Callahan. Additional development by Jason Holt. Partnership with local news outlets coordinated by María Sánchez Díez.
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