WMBF Investigates: Federal data shows opioid distribution on the decline, but S.C. still ranks high

Updated: Feb. 5, 2020 at 8:37 PM EST
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MYRTLE BEACH, S.C. (WMBF) - The distribution of opioids decreased by around 15% nationwide in the first half of 2019, according to WMBF’s analysis of data from the U.S. Drug Enforcement Administration (DEA).

The federal database, ARCOS, tracks and monitors drugs from manufacturer to distributor to seller.

WMBF Investigates decided to analyze the data for the most prescribed opioids, including, fentanyl, codeine, morphine, oxymorphone, hydrocodone, and oxycodone.

Data reveals around 14% fewer grams of the drugs were distributed in South Carolina from January 2019 to June 2019 than at the same time frame the year before.

The DEA uses this data to help strengthen criminal cases in court but the information on the path of these drugs can also help experts gain better insight on the severity of the opioid epidemic.

According to the U.S. Accountability Office, 48,000 people died from an opioid overdose in 2017. South Carolina ranked 20th for most opioid-involved overdose deaths per people in 2017, according to the National Institute on Drug Abuse.

Factors impacting the decrease of opioids

Local healthcare experts said they aren’t surprised by the findings.

Dr. Paul Richardson attributed the decline to three factors: education, prescription tracking databases and alternative pain control methods.

“All drugs have potential side effects and I think what we've come to learn is the side effects of opioids are they're not as benign as, they're not benign drugs. And so now people are starting to be educated about it. That's made a huge difference,” Richardson said.

In recent years, there’s been a national increase in regulation on how much of a drug that doctors can prescribe and increase attention on logging and tracking that information.

The national prescription monitoring program requires professionals to log prescriptions to help combat drug abuse.

“Prescription drug monitoring programs (PDMPs) continue to be among the most promising state-level interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk,” stated the Center for Disease Control and Prevention.

Richardson said at the hospital, doctors are starting to do more robotic surgeries because studies have shown it leads to less pain afterward.

“As providers, we have more tools at our disposal than we ever had,” he said. “There’s all sorts of modalities now in the pain management realm… nerve simulators and this kind of thing that we didn’t have access to even a few years ago, several years ago. So, all this is kind of sort of coming at the right time.”

The federal database shows only 3.5% of the 2019 drugs were distributed to hospitals. Pharmacies distributed 96% of the opioids in 2019.

Sam Ibrahim owns Carolina Forest Pharmacy and also credited alternative opioid-control methods to the decrease.

“Pharmacists are looking into multiple ways to help their patients, not just pain pills. Number one, we are looking into each patient, evaluating them,” Ibrahim said. “Number two, for patient who has pain… there are other alternatives in addition to pain drugs. That can include CBD use, turmeric, other herbal supplements.”

He said the expansion of options is making a difference and he’s seen more people decreasing their medication by using herbal supplements.

How the state stacks up

In the past, South Carolina has ranked high nationwide for its prescription of opioids per person.

In July, the Washington Post analyzed the DEA database on shipments of oxycodone and hydrocodone pills.

The analysis found South Carolina distributed 60.9 pills per person per year from 2006 to 2014. Only West Virginia and Kentucky ranked higher.

The DEA excluded oxycodone totals from its 2018 report, but WMBF found 348,165 grams of oxycodone was distributed to the South Carolina in the first half of 2019.

Without including the drug, WMBF found the state received 436,000 grams of fentanyl, codeine, morphine, oxymorphone and hydrocodone.

Including oxycodone distribution total increases South Carolina’s overall opioid total by 80%.

Oxycodone, hydrocodone and codeine are the top three drugs distributed to South Carolina, based on WMBF’s analysis.

WMBF did not include oxycodone for more accurate comparison to the DEA 2018 report, which excludes the drug.

Overall, the new data shows the Palmetto State received 14% fewer grams of drugs for the first half of 2019.

Despite the decline, the DEA data shows the Palmetto State actually rose in its rank for almost every drug distributed per 100,00 people, based on population figures included in the report. The state ranks in the top half of the country for every drug tracked.

DRUG2019 ranking (half year)2018 ranking
Fentanyl Base22nd25th

Richardson said he believes continuing education is the key to decreasing the numbers. He said a big part of education is resetting patients’ expectations on pain.

“The bottom line is pain medication is going to be a part of medical practice,” he said. “I think just being more judicious is the key here. Complete elimination, in my opinion, is not possible.”

Ibrahim agreed. He said, “This is not a war on pain.”

He explained medical professional are turning away from the practice of using pain charts to evaluate patients’ needs.

“They started coming up with those charts for pain, which has zero as no pain and 10 as the worse pain you have had in your life,” Ibrahim said. “People start picking eight and 10 and nine and that doctor wanted to treat these patients and that led to the increase in that amount of pain pills.”

At the end of the day, he said a little bit of pain is normal.

“We’re trying to be good stewards of opioids, antibiotics. I mean really, all our medications, because you know, we overuse antibiotics as a bad thing. We overuse opioids. That’s a bad thing. So really, I think as, as providers, it’s being good stewards of, of everything that we do medically,” Richardson said.

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