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FILE - This Tuesday, Aug. 15, 2017, file photo shows an arrangement of pills of the opioid oxycodone-acetaminophen 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/Patrick Sison, File)

ASHLAND — Government data show during a seven-year period, more than 141 million opioid prescription pills were shipped to four rural Appalachian counties bordering West Virginia's southwestern border, which attorneys say fueled the opioid epidemic and made the area one of the most affected places in the country.

In those four counties - Boyd, Lawrence and Pike counties in Kentucky and Lawrence County, Ohio - two manufacturers made 80% of the pills, with Actavis Pharma Inc. creating 45% of the pills and SpecGx LLC accounting for 35%.

Distributor AmerisourceBergen accounted for more than a quarter of pills - 37.2 million - distributed in those counties, with more than 27.7 million of those being dispensed in Pike County alone.

Those who are addicted to prescription opioid painkillers are 40 times more likely to become addicted to heroin, according to the Centers for Disease Control and Prevention. When the number of prescription pills sent to the areas decreased, its users turned to illegal substances, like heroin, to cope with their withdrawal symptoms, contend plaintiff attorneys in about 1,800 lawsuits filed by local governments seeking damages from drug manufacturers and distributors for the opioid crisis.

The Drug Enforcement Administration's ARCOS data from which these statistics come was recently turned over to HD Media, which owns The Herald-Dispatch and Charleston Gazette-Mail, and The Washington Post after a year-long battle in which the drug companies and DEA wanted to keep the data out of the public eye after it was turned over to the plaintiff attorneys in those cases.

The Automation of Reports and Consolidated Orders System (ARCOS) is a DEA database that compiles transactions made by drug manufacturers, distributors and pharmacies.

U.S. District Judge Dan Polster - who is overseeing those federal cases - ordered data collected from 2006 to the end of 2012 be released earlier this month after the U.S. 6th Circuit Court of Appeals said his previous blanket order sealing the data was an abuse of power.

Companies shipped 1,901,662,933 pills to the commonwealth of Kentucky during that period, equating to about 61 pills per person per year.

Pike County, Kentucky, was the worst hit in that state. It received 66,785,120 prescription pain pills while having a population of about 58,000 - around 146 pain pills per person per year. Pike is across the border from Mingo County, West Virginia, which received 203 pills per person per year. Both are among the highest pills per person per year in the country.

At 44.3 million pills, Actavis manufactured more than four times the amount of pills as SpecGx - 11 million. Par Pharmaceutical accounted for 6.3 million; UCB Inc., 2.1 million; and Amneal Pharmaceuticals, 688,000 for Pike County's numbers.

AmerisourceBergen Drug distributed more than 40% of those pills - 27.7 million. McKesson Corp. distributed 12.8 million; Cardinal Health, 8.6 million; Walmart, 3.3 million; and The Harvard Drug Group, 3 million.

Economy Drug Co. Inc. in Pikeville led pharmacies in dispensing 5.5 million pain pills, followed by Total Pharmacy Care (Pikeville), 5.3 million; Elkhorn Drug (Elkhorn City), 5.2 million; Family Pharmacy (South Williamson), 4.2 million; and Parker Professional Pharmacy (Pikeville), 4.3 million.

Pike County had an overdose rate of 33 per 100,000 residents in 2008, more than double Kentucky's overdose death rate, and it jumped to about 40 in 2011 before dropping to about 31 in 2014.

Boyd County, Kentucky - population of about 48,000 - received 36,819,430 of those same prescription pain pills, which amounts to about 107 pills per person per year. That's about 10 more per person per year than seen in Cabell County, West Virginia. Manufacturer SpecGx also accounted for more than half of those pills, at 20.4 million, well ahead of Actavis, 8 million; Par Pharmaceutical, 5 million; Purdue Pharma, 1.2 million; and Amneal, 807,000.

Walmart pharmacies in Ashland dispensed more than 8.5 million of the pills (River Hill Drive location, 4.4 million, and U.S. 60 location, nearly 4.1 million), with the CVS in Ashland dispensing 4 million; Broadway Clinic, Ashland, 3.3 million; and McMeans Pharmacy in Ashland, 3.2 million.

Companies also shipped 12,053,770 pills to Lawrence County, Kentucky, with a population of about 15,700. That amounts to about 109 pills per person per year.

Cardinal Health distributed more than twice the amount of pills - 4.5 million - than AmerisourceBergen and McKesson, which shipped 2.2 million each. Quest Pharmaceuticals distributed 1.3 million and Rite Aid, 701,000. Actavis Pharma led manufacturers with 5.57 million pills, followed by SpecGx LLC, 3.9 million; Par Pharmaceutical, 1.7 million; Amneal Pharmaceuticals, 443,000; and Purdue Pharma, 218,000.

The top five dispensing pharmacies were from Louisa and included Paradise Enterprises, 3.7 million; Louisa Prescription Center, 2.5 million; Lawrence Retail Co., 2.3 million; Rite Value Pharmacy, 1.8 million; and Rite Aid, 1 million.

In 2017, Boyd County ranked the third highest in overdose deaths among Kentucky's 120 counties, with a rate of 64.6 per capita. Boyd County Coroner Mark Hammond said his statistics show the county had 38 deaths.

Across the river, the state of Ohio saw nearly 3.4 billion opioid pills dispensed in the state from 2006 to 2012. With a population of about 11.69 million, that amounts to about 41 pills per person per year.

Lawrence County, Ohio, which has a population of about 60,000 residents, had 26,040,425 oxycodone and hydrocodone pills distributed between 2006 and 2012, or about 62 pills per person per year.

Manufacturer SpecGx LLC accounted for more than half of those at nearly 13.7 million pills. The remaining top manufacturers include Actavis Pharma Inc., 5.9 million; Par Pharmaceutical, 3.6 million; Amneal Pharmaceuticals, 1.2 million; and Purdue Pharma, 535,000.

Distributor Cardinal Health distributed the most pills at nearly 5.5 million. CVS distributed 4.7 million; Walmart, 3.4 million; Miami-Luken, 2.7 million; and AmerisourceBergen Drug, 2.1 million.

Just five pharmacies throughout the county distributed half of the 26 million pills. Proctorville's Fruth Pharmacy dispensed nearly 3.5 million of those pills, South Point Walmart, 2.7 million; Chesapeake CVS, 2.4 million; Ironton CVS, 2.4 million; and Ironton's Coal Grove Pharmacy, 2.2 million.

In June, the Lawrence County Board of Commissioners was told drug overdoses in the county were significantly down from 24 in 2018 to just three as of June. County ambulance crews had to deal with 46 overdoses in April 2017. A year later, the number was 28, and just 19 at that time in 2019. They credited a quick response team, which helps connect people with drug counselors soon after an overdose.

The county faced an overdose death rate of 41 per 100,000 in 2015 and 42 in 2016. The number jumped to about 57 in 2017.

Follow reporter Courtney Hessler at Facebook.com/CHesslerHD and via Twitter @HesslerHD.

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