Americans Drug Use (copy)

This Aug. 29, 2018 photo shows an arrangement of prescription Oxycodone pills in New York. (AP Photo/Mark Lennihan)

Editor's note: New information released Thursday showed the reason for the high concentration of opioid pills in Charleston is due to the presence of a consolidated, mail-order pharmacy center operated by Veterans Affairs. Read more here.

Charleston County has distributed the highest concentration of opioid pain pills of any county in the nation, a Washington Post analysis of federal drug enforcement data over a span of recent years shows.

A federal judge's ruling Monday freed secret Drug Enforcement Administration data showing the path of opioid pills from manufacturers to community pharmacies and finally to the public. It offers a glimpse into the severity of the epidemic in Charleston County.

Here, an average of 248 pain pills were distributed for every county resident in every year from 2006 to 2012. Across the state, 1.8 billion pills were dispensed during those years. Apparently, due to the flow of the addictive pills into Charleston County, South Carolina had the third-highest share of the billions of painkillers that made their way into Americans' medicine cabinets over that time.

The Post released the data and conducted the analysis. The paper, along with The Charleston Gazette-Mail in West Virginia, argued against the Justice Department in federal court to force the release of the information. 

Meanwhile, 94 people died from an opioid overdose in Charleston County in 2017, more than anywhere else in the state that year, mostly due to the illegal drugs fentanyl and heroin. Charleston County government is one of only a handful left in South Carolina that has declined to sue opioid manufacturers and distributors for their role in fueling addictions and overdoses.

Charleston County Council Chairman Elliott Summey did not return calls or an email seeking comment.

In an Ohio court, lawyers for the Justice Department argued that releasing the data would be cumbersome, could impede DEA investigations and "is of limited use to the general public." Some of the transactions the database records could also be errors, the lawyers wrote last Friday.

Still, the newspapers prevailed. U.S. District Judge Dan Polster wrote in an order Monday "there is clearly no basis to shield from public view" the data, partly because the transactions are dated before the end of 2012.

The release comes against the backdrop of hundreds of lawsuits making their way through federal court under Polster's watch, as governments try to win money back to pay for the costs of healing the widespread effects of the overdose epidemic.

Joe Rice, a Charleston attorney with Motley Rice who is one of a few lawyers leading the litigation, said he has had access to the data for about a year. It has been important to the discovery process as lawyers near the start of a trial in October. Leading attorneys on the litigation support the data being released, Rice said.

"They were reluctant to open the door," he said. "It’s frankly going to be important for law enforcement and public health."

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Called the Automation of Reports and Consolidated Order System, the database offers the most detailed view to date of the flow of hundreds of millions of opioid pills into the hands of Americans.

The volume of pills coming into Charleston County raises serious questions that the database alone doesn't answer.

The epidemic's toll here has not been as severe as it has been elsewhere. South Carolina has a middling death rate due to drug overdoses, according to the Centers for Disease Control and Prevention. The Palmetto State's overdose death rate in 2017 was less than half that of West Virginia, Ohio and Pennsylvania.

And Charleston County has had a relatively modest rate of prescriptions of opioid pills. CDC data shows those prescriptions at their highest rate in Charleston in 2012, at about 94 pills given out for every 100 people. Mingo County in West Virginia, by comparison, peaked at 437 pills dispensed per 100 people in 2009.

A spokesman for the S.C. Department of Alcohol and Other Drug Abuse Services said the agency doesn't have any information pointing to a reason behind the high concentration of pain pills in Charleston County.

The information The Washington Post presented is several years old and includes only prescriptions for two opioids, hydrocodone and oxycodone, the most commonly prescribed legal painkillers. 

Reach Mary Katherine Wildeman at 843-937-5594. Follow her on Twitter @mkwildeman.