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Leavenworth County, Kansas, May Not Be The Catastrophic Opioid Hotspot That New Data Appear To Show

The Washington Post
This map shows how much hydrocodone and oxycodone went to individual states and counties. The information comes from a DEA database. The Washington Post and Charleston Gazette-Mail in West Virginia waged a year-long legal battle for its release.

A newly released database shows that Leavenworth County, Kansas, had one of the highest concentrations of opioid pills per person in the United States between 2006 and 2012.

While those numbers might suggest a hidden calamity in eastern Kansas, the vast majority of those pills were actually processed by a Veteran’s Administration fullfillment center, rather than distributed locally, according to the data.

The figures come from a database maintained by the U.S. Drug Enforcement Administration and obtained this week by The Washington Post through a Freedom of Information Act request. The Post analyzed the data and calculated the number of pills distributed per person by county.

The figure for Leavenworth County is significantly higher than those in some of the country’s most hard-hit opioid hotspots, including southern Kentucky, northern Tennessee and West Virginia. At 226.5 opioid pills per person, the county was surpassed only by Charleston County in South Carolina, at 248 pills per person.

But it turns out more than 100 million of the pills were distributed by the Veteran’s Administration Mail Outpatient Pharmacy, accounting for more than 89% percent of the pills supplied to Leavenworth County during the period.

Elaine M. Buehler, a spokeswoman for the U.S. Department of Veterans Affairs, said the pharmacy is a regional fulfillment center that fills prescriptions submitted from multiple VA facilities around the country. 

The presence of mail order pharmacies in The Post’s data appears to skew the numbers in other counties as well.

For example, the data show that  166,185,694 opioid pills were distributed in Johnson County, Kansas. But more than 50 million were distributed by OptumRX, a mail order pharmacy company with a large distribution center in Overland Park.

And Charleston County, South Carolina, which was listed as having 248.3  pills per person, is also home to a VA fullfillment center. That pharmacy accounted 85% of the 596,206,074 pills distributed in the county.

Credit The Washington Post

The rate in Leavenworth County peaked in 2007, followed by a sharp decline in 2009.

Leavenworth County health and law enforcement officials did not immediately return calls seeking comment about the extent of the opioid problem in the county.  

But unlike many counties that have been hotspots for opioid abuse, Leavenworth County does not have a high overdose rate, and the county’s rates of premature death are relatively low.

The opioid pill data, which drug manufacturers and distributors were required to provide to the DEA, show that more than 76 billion pills were distributed in the United States over the seven-year period in question. During that time, nearly 100,000 people died of opioid overdoses.

Though the opioid epidemic may not have hit Leavenworth County as hard as other parts of the country, the county recently joined some 2,000 other cities, towns, attorneys general and tribal nations that have sued opioid manufacturers and distributors. The suits allege the companies were complicit in creating the opioid epidemic that has killed an estimated 68,000 Americans in 2018 alone.

The suits have been consolidated in federal court in Cleveland, where The Post and the Charleston Gazette-Mail asked the judge to lift a protective order covering the opioid database, known as ARCOS. After he denied the request, the newspapers appealed and last month a federal appeals court sided with the newspapers. On Monday, the judge lifted the protective order and made the data from 2006 through 2012 available to the public.

Alex Smith is a health reporter for KCUR. You can reach him by email at alexs@kcur.org

As a health care reporter, I aim to empower my audience to take steps to improve health care and make informed decisions as consumers and voters. I tell human stories augmented with research and data to explain how our health care system works and sometimes fails us. Email me at alexs@kcur.org.
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