Act 1 — Scale
76 billion pills.
Between 2006 and 2014, pharmaceutical distributors reported 0 billion doses of oxycodone and hydrocodone to the DEA. The curve rises through 2010 and then turns.
2006–2014
Where the pills went, who sent them, and who paid.
76Bpills shipped across the United States in nine years. This site follows the pill through the distribution system — and counts what came after.
Show data
| Year | Pills |
|---|---|
| 2011 | 11,154,554 |
| 2012 | 10,228,229 |
| 2013 | 9,298,563 |
Act 2 — Distributors
Three companies.
McKesson, Cardinal Health, and AmerisourceBergen together moved most of the pills. Their share shifted, but the trio stayed on top.
Show data
| Distributor | 2006 share | 2014 share |
|---|---|---|
| MCKESSON CORPORATION | 37.9% | 37.9% |
| CARDINAL HEALTH | 25.9% | 25.9% |
| AMERISOURCEBERGEN DRUG CORPORATION | 20.6% | 20.6% |
| H.D. SMITH WHOLESALE DRUG CO | 10.2% | 10.2% |
| MIAMI-LUKEN INC | 5.5% | 5.5% |
Act 3 — Enforcement
The regulators catch up.
Enforcement actions from the DEA Diversion Control Division climbed through 2012–2013 as the scale of the problem became impossible to ignore.
Show data
| Year | Actions | Notable |
|---|---|---|
| 2012 | 1,245 | United States v. Florida Pain Relief Centers; United States v. Tug Valley Pharmacy; Operation Pill Nation II was a multi |
| 2014 | 1,418 | United States v. Appalachian Wholesale; United States v. Mingo Family Pharmacy; Operation Supply Chain targeted large distributor diversion |
Act 4 — Aftermath
The counties left behind.
The pills came in waves; the deaths followed. These six counties carried some of the heaviest per-capita shipments — and some of the steepest casualties.
Show data
| County | Years | Deaths (first→last) |
|---|---|---|
| Mingo County (WV) | 2 | 0 → 15 |
| Norton city (VA) | 0 | 0 → 0 |
| 54011 () | 0 | 0 → 0 |
| 54045 () | 0 | 0 → 0 |
| 21071 () | 0 | 0 → 0 |
| Pike County (KY) | 0 | 0 → 0 |