How 1.5 billion painkillers flooded N.J. and sparked an epidemic that’s killed nearly 20K people

1.5 billion pills. Nearly 20,000 dead

New data shows how the pharmaceutical industry funneled more than a billion pills into New Jersey over a seven year period.

More than 1.5 billion. That’s billon, with a 'b'.

That’s how many prescription pain pills landed in New Jersey from 2006 through 2012, according to a Drug Enforcement Administration database published this week by The Washington Post.

If the pills were distributed equally to everyone currently in the state, you would get more than 170.

Those painkillers were kindling to a fire that has killed thousands. During that seven-year period, more than 6,000 people died in New Jersey of drug overdoses. But as prescription pills gave way to heroin and then fentanyl, what was to come was even worse.

Today, the drug death rate in New Jersey is 67% higher than the nation overall.

This database provides an unprecedented look at the role specific manufacturers, distributors and pharmacies played in the Garden State’s opioid epidemic. Each are a leg in a supply chain that many believe sparked an ongoing drug crisis that now annually kills more people in New Jersey than car accidents, guns and the flu combined.

The data shows shipments of prescription opioids steadily increasing through the late 2000s, cresting at more than 240 million in 2011 alone. Here, it was the bedrock for for a scourge of drug use that left hundreds of thousands addicted and tens of thousands dead.

That New Jersey was in line with the national average for the period shows the breadth of the prescription opioid boom. During the seven-year span the data covers alone, more than 76 billion pills were shipped nationally.

While data from the state’s prescription drug monitoring program shows opioid sales in New Jersey have dropped precipitously since 2015, it was the precursor to the spread of heroin and fentanyl across the state, accelerants that produced a wave of drug deaths yet to abate.

The Manufacturers

It begins with the pill makers. Just five companies shipped more than 90 percent of prescription opioids to New Jersey between 2006 and 2012 — combining to produce more than 1.3 billion pills.

SpecGx LLC tops the list. Owned by U.K.-based Mallinckrodt LLC, the company produced nearly 600 million pills that found their way into New Jersey pharmacies. The manufacturer, which has an office in Bedminster, has been under fire in recent years after a spike in prescriptions for their main drug Acthar, used to treat rare infantile spasms. Mallinckrodt allegedly promoted its use for 18 other treatments even when there was very little evidence available on its efficacy.

Purdue Pharma, the now infamous creator of OxyContin, sent nearly 100 million pills to New Jersey. In May, New Jersey sued Purdue’s longtime owners, the Sackler family, for their role in the opioid crisis.

“Despite knowing the harms that would result, the Sacklers drove Purdue to pursue deceitful sales campaigns for OxyContin and other highly addictive opioid painkillers, campaigns that were dutifully carried out by a small army of the company’s employees," New Jersey Attorney General Gurbir Grewal said at the time. "Our communities are still reeling from the epidemic of addiction and overdose deaths caused by their misconduct.”

The company itself has been sued in federal court by nearly 2,000 cities, towns and counties, including the Garden State. Plaintiffs say the company flooded the country with pain pills while they knew that overdose deaths were quickly rising.

The Distributors

The next leg in the supply chain was the distributors.

The top five distributors in N.J. made up 74.12% of the total.

Topping the list was Cardinal Health, who distributed 308,118,943 pills, or 20.28% of market share. Headquartered in Dublin, Ohio, the company reported nearly $130 billion in annual revenue in 2018. Cardinal Health has also been sued for their role in the drug crisis, accused of ignoring suspicious orders as demand exploded.

Also fueling the flow of pills to New Jersey pharmacies were the distribution arms of several household names in the pharmacy business, such as Walgreens, CVS, Rite Aid and Wal-Mart.

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The Pharmacies

Pharmaceutical distributors pushed opioids into pharmacies in every corner of the state, many of which received millions of pills each.

But map the top 100 pharmacies and a roadmap for the devastation to come reveals itself. The data shows pills flowing like water into pharmacies in places like Atlantic, Camden, Essex, Gloucester and Ocean Counties, which in the years that followed would become the epicenters for drug overdose spikes in the state.

Pill shipments were most concentrated in South Jersey, peaking at 296 pills per person in Camden County over the seven-year period, compared to 105 in Hudson County. This mirrors a national trend of the country’s poorest and most rural areas receiving an outsized portion of the opioids sold nationwide.

Partners Pharmacy in Springfield was by far the largest buyer of pain pills from 2006 to 2012. The pharmacy chain provides medications to nursing facilities and assisted-living centers.

The aftermath

What happened next is well documented.

The steady flow of legal opioids ultimately laid the foundation for the far more deadly waves of the crisis wrought by heroin and fentanyl.

In the early 2010s, the state became aware of the prescription drug problem. Additional scrutiny began to stem the tide of prescription opioids.

As it did, tens of thousands who had become dependent on opioids turned to heroin, a far cheaper, more powerful and soon, more readily available alternative. Places like Newark, Paterson and Camden became open-air drug markets.

By 2015, NJ Advance Media estimated there were at least 128,000 opioid users in New Jersey.

In the same year, fentanyl, a synthetic opioid several times more powerful than heroin began appearing on the streets.

The death toll started rising exponentially.

In 2015, 1,587 people died from drug overdoses. In 2016, 2,221. Then 2,750. Last year, more than 3,100 people died of drug overdoses in the Garden State, a nearly four-fold increase since 2006.

Today, the overdose death rate in New Jersey far outpaces the nation. Last year, drug deaths fell by 5 percent nationally, the first decline since 1990. In New Jersey, they rose 14%.

Since 2006, at least 19,600 people have died of drug overdoses in New Jersey, the vast majority due to opioids in their various forms.

Stephen Stirling may be reached at sstirling@njadvancemedia.com. Follow him on Twitter @sstirling. Find him on Facebook.

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