Overdoses soared even as prescription pain pills plunged

The number of prescription opioid pain pills shipped in the United States plummeted nearly 45 percent between 2011 and 2019, new federal data shows, even as fatal overdoses rose to record levels as users increasingly used heroin, and then illegal fentanyl.

The data confirms what’s long been known about the arc of the nation’s addiction crisis: Users first got hooked by pain pills saturating the nation, 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 drug industry transaction data, collected by the Drug Enforcement Administration and released Tuesday by attorneys involved in the massive litigation against opioid industry players, reveals 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, according to a Washington Post analysis of the DEA data and federal death records.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.

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