Another Fine Mess

Blogger Comments:  This story is a good read.  Some of the poorest counties in Alabama had the highest rate of prescription drugs.  Prescription drugs are killing Alabama citizens.  Who do you blame the drug companies, the physicians, the users?  It's time to hold those accountable for making and distributing opioids to citizens as if it were candy.  

https://www.al.com/news/2019/07/where-the-opioid-epidemic-hit-hardest-alabama.html

Where the opioid epidemic hit Alabama hardest

Updated Jul 21, 8:31 PM; Posted Jul 21, 7:50 AM

By Ramsey Archibald | rarchibald@al.com

According to new data obtained and shared by the Washington Post, a now-closed pharmacy called D&L Pharmacy in rural south Alabama received more than 1.3 million prescription opioid pills between 2006 and 2012. Gilbertown, located in Choctaw County near the Mississippi line, claims fewer than 200 people, according to the U.S. Census Bureau. It’s not near any population centers.Yet more than 1.6 million pain pills moved through Gilbertown over that span. That’s nearly 1,500 pills per person per year - nearly double the per capita rate of the next highest town in Alabama.

The Washington Post obtained the pain pill prescription data from the Drug Enforcement Administration. It tracks the path of every hydrocodone and oxycodone pill sold legally in the United States between 2006 and 2012, tracing movement from manufacturer to distributor to pharmacy.

More than 76 billions pills were distributed across the country during the timeframe. More than 1.7 billion of those pills made their way to Alabama.

Gilbertown’s small population explains some of its ballooned opioid rate, but the opioid epidemic in Alabama seemed to disproportionately hit rural areas, and specifically towns in rural, predominantly white counties across north Alabama.

Of the top 10 cities and towns by opioid rate per capita, only Gilbertown is in south Alabama.Yet more than 1.6 million pain pills moved through Gilbertown over that span. That’s nearly 1,500 pills per person per year - nearly double the per capita rate of the next highest town in Alabama.

The Washington Post obtained the pain pill prescription data from the Drug Enforcement Administration. It tracks the path of every hydrocodone and oxycodone pill sold legally in the United States between 2006 and 2012, tracing movement from manufacturer to distributor to pharmacy.

More than 76 billions pills were distributed across the country during the timeframe. More than 1.7 billion of those pills made their way to Alabama.

Gilbertown’s small population explains some of its ballooned opioid rate, but the opioid epidemic in Alabama seemed to disproportionately hit rural areas, and specifically towns in rural, predominantly white counties across north Alabama.

Of the top 10 cities and towns by opioid rate per capita, only Gilbertown is in south Alabama.

Here's the cities and town that had the highest rate of opioids between 2006 and 2012.

Four of the top 10 Alabama cities or towns for opioid rate are in Walker County, which had the highest rate for any entire county in Alabama during the timeframe from 2006 to 2012. According to the data, each year 140 pills per person went through Walker County, a coal-mining region just northwest of Birmingham.Pharmacies in Walker County received nearly 9 million pills a year there, in a county with fewer than 65,000 people. David’s Discount Pharmacy in Sumiton, Alabama, led the way in Walker County. It received more than 9 million pills between 2006 and 2012. Sumiton has a population of just over 2,600 people.

More than 458 prescription pain pills per person per year passed through Jasper, the largest city in Walker County. It’s the only city with a population over 10,000 and an opioid rate higher than 270 pills per person per year, according to the data.

That means, in some ways, Jasper was the epicenter of the opioid problem in Alabama. No other large Alabama city made the top 28. No county saw more prescriptions per person than Walker County. And no county seat in Alabama saw more prescriptions per person than Jasper.

The federal data is also broken down by individual pharmacy. And while the pharmacies in larger cities tended to see more business and more pills moving through the door, Walker County also made that list. 

David’s Discount Pharmacy in the small town of Sumiton in Walker County was third in the state in terms of total prescription opioid pills received from 2006 to 2012. The pharmacy appears to be closed. The pharmacy with the most total prescription pain pills was Senior Care Pharmacy in Northport, in Tuscaloosa County. It was the only pharmacy in the state to receive more than 10 million pills over the time frame, according to the data. Representatives from that pharmacy have not responded to AL.com’s request for comment.

The Alabama pharmacies with the second- and fourth-highest number of pills for are located in Huntsville and owned by the same person. Propst Discount Drugs and Star Discount Pharmacy collectively received 17.5 million pills. A representative of the pharmacy referred questions to the owner, who is out of town. He has not yet responded to an email from AL.com.

All of the top five pharmacies in terms of volume were in north Alabama.

By just about any measure, the opioid epidemic in Alabama hit hardest in poor, rural and white areas in north Alabama, in a seeming band stretching across the hilly stretches from Georgia to Mississippi.

Among the top 10 counties in opioid prescriptions per capita, only Covington County near the Florida Panhandle is in the southern half of the state. And none of the top ten counties are less than 80 percent white.

The biggest hot spot can be seen in rural northwest Alabama, near Mississippi, starting with Walker County and moving northwest through Winston, Marion, Franklin and Colbert counties.

These are the top five counties in the state in terms of hydrocodone and oxycodone pills per person per year, and they form an unbroken region in the northwest corner of the state.

Washington County in southwest Alabama had the lowest rate in the state. Pharmacies there only received 9.1 prescription pain pills per person per year.

In general, Black Belt counties also had low rates. Wilcox, Lowndes, Greene and Coosa round out the five counties with the lowest rates, according to the data.

In 2017, Alabama had the highest opioid prescription rate in the country, nearly twice as high as the national average, according to the federal government’s National Institute on Drug Abuse. And that rate had even declined from a few years earlier. In 2011, Alabama providers wrote nearly 144 prescriptions for every 100 people.While opioid prescriptions are now down nationwide, including in Alabama, problems remain.

Last year, Alabama had the highest proportion of Medicare recipients receiving opioids in the country, according to a report by the U.S. Department of Health & Human Services. And signs point to serious misuse. One Alabamian received 56 opioid prescriptions in a single year, ordered by 25 prescribers and filled at five pharmacies, according to the report.

Alabama has had a Prescription Drug Monitoring Program since 2006. It’s a database created to keep track of prescriptions in Alabama, to prevent prescription drug abuse and misuse by patients and overprescribing by doctors. But with the state’s abysmal track record on opioids over the past decade, state leadership has called for improvements.

In 2017 Gov. Kay Ivey convened the Alabama Opioid Overdose and Addiction Council, which developed an action plan that, among other things, recommended funding to strengthen the Alabama Prescription Drug Monitoring Program.

In the meantime, insurers began stepping in. Beginning in May of this year, Alabama Medicaid began limiting the daily dosage amount of opioids allowed on claims. Blue Cross Blue Shield of Alabama stopped covering OxyContin for most of its members.