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Opioid Overdoses Rose Despite Pain Pill Shipments Decreasing

The number of prescription opioid pain pills shipped in the U.S. plummeted nearly 45 percent between 2011 and 2019, new federal data show, even as fatal overdoses rose to record levels as users increasingly used heroin, and then illegal fentanyl. The data confirm what’s long been known about the arc of the nation’s addiction crisis: Users first got hooked by pain pills, then turned to cheaper and more readily available street drugs after law enforcement crackdowns, public outcry and changes in how the medical community views prescribing opioids to treat pain. The Washington Post sifted through 760 million transactions from 2006 through 2019 that are detailed in the Drug Enforcement Administration’s database and analyzed shipments of oxycodone and hydrocodone pills, which account for three-quarters of the total opioid pill shipments to pharmacies. Find the full database here. The drug industry transaction data, collected by DEA and released Tuesday by attorneys involved in the massive litigation against opioid industry players, shows that the number of prescription hydrocodone and oxycodone pills peaked in 2011 at 12.8 billion pills, and dropped to fewer than 7.1 billion by 2019. Shipments of potent 80-milligram oxycodone pills dropped 92 percent in 2019 from their peak a decade earlier. Many of the counties with the highest fentanyl death rates — in hard-hit states such as West Virginia, Kentucky and Ohio — started out with alarmingly high doses of prescription pills per capita. Counties with the highest average doses of legal pain pills per person from 2006 to 2013 suffered the highest death rates in the nation over the subsequent six years. Annual overall overdose deaths reached a grim milestone in 2021, surpassing 100,000 for the first time in U.S. history. More than 110,000 people died of drug overdoses in 2022, two-thirds of whom succumbed to synthetic opioids such as fentanyl, according to estimates by the Centers for Disease Control and Prevention.

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