DEA data: Berkshire County 3rd highest in state for per-person opioid prescriptions

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Drug companies supplied Berkshire County pharmacies and health care practitioners with more than 32 million pain pills from 2006 to 2012, according to recently released Drug Enforcement Administration data.

The volume of opioid drugs delivered to the county helps explain the current heroin epidemic, according to Jennifer Kimball, coordinator at the Berkshire Opioid Addiction Prevention Collaborative.

"I think we're no different than most other regions in the United States, and now it's in front of us in black and white," Kimball said of the DEA data, which was obtained through court action by The Washington Post. "We're on to heroin and fentanyl now, but we certainly know where this crisis had its origin."

The Post and HD Media waged a yearlong legal battle for access to the DEA's Automation of Reports and Consolidated Orders System, which stored data related to the prescription pain medications hydrocodone and oxycodone.

In Massachusetts, Berkshire County was supplied with the third-highest number of those pills per person each year. Dukes County, which includes Martha's Vineyard and the scarcely populated Elizabeth Islands, came in first, at 38.5 pills per person. Hampden County was next, at 37.5, according to the data.Berkshire County followed, at 35.5.

Kimball said it would be difficult to say what the "per person" number should look like for regions like Berkshire County. What she can say, though, is that it shouldn't have been as high as it was.

"There will always be a need for opioid medication, as we know with chronic long-term pain, but opioids were egregiously overprescribed," Kimball said. "It's not rocket science to say the number should be much, much lower."

Big three

Three companies distributed nearly half of the pills in the United States: McKesson, with 14.1 billion; Walgreens, with 12.6 billion; and Cardinal Health, with 10.7 billion, according to the Post's analysis. The leading manufacturer was Mallinckrodt's SpecGx, with nearly 28.9 billion pills, or about 38 percent of the market.

Massachusetts counties were supplied with far fewer pills per person than those in other states.

Rural areas of the country had been supplied with more than 150 pills per person per year.

The data depicts an "opioid belt" of more than 90 counties stretching southwest from Webster County, W.Va., through southern Virginia and ending in Monroe County, Ky.

"This swath includes 18 of the top 20 counties ranked by per-capita prescription opioid deaths nationwide and 12 of the top 20 counties for opioid pills distributed per capita," the Post reported.

While Berkshire County had a higher rate of pills distributed than nearby Hampshire and Franklin counties, it might have been related to the age of its population.

About 23 percent of Berkshire County residents are 65 or older, according to the most recent U.S. census.

Michael Leary, spokesman for Berkshire Health Systems, notes that chronic pain is associated with older people. "Berkshire County has a disproportionate number of senior citizens who may suffer from that chronic condition, accounting for a greater need for pain remedies locally than may occur in other areas of the state," he said in a statement.

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A change in tides

Today, Berkshire health care providers are more cautious with how they prescribe opioid medications than they were in 2012, and that's reflected in Massachusetts Prescription Monitoring data, officials say.

For the past 15 years, Berkshire Health Systems, the largest health care provider in the county, has sponsored a task force with physicians and community members to "address the challenges of caring for patients in chronic pain while limiting the risk of misuse of pain medications," Leary said.

The organization acted before a state law required prescribers to check the state's prescription monitoring program, he said, requiring its physicians to do so. "BHS has also promoted alternatives to pain management."

Dr. Kavita Bavu, an emergency room physician at UMass Memorial Medical Center in Worcester and chief of the division of toxicology, said Berkshire County is trending down in the number of opioid prescriptions written.

"I wouldn't suggest that we take too much from the study other than historical perspective," Bavu said in a statement. "Berkshire County looks much different than it did in 2012 with respect to prescribing."

While overprescribing still is happening, today the real battle in Berkshire County, and across the country, is to combat the use of heroin and fentanyl, Kimball said.

State Department of Public Health statistics show that 40 people died last year from an opioid-related overdose in the Berkshires. From 2010 to 2018, there were 210 overdose deaths in Berkshire County, according to the DPH.

This epidemic was "fueled by the aggressive and unethical marketing practices by the pharmaceutical industry," Kimball said.

When pills became harder to get, and therefore more expensive to buy on the street, addicts turned to heroin, Kimball said.

Valuable data

Kimball said she is thankful for the Post's efforts in fighting for the DEA data, which will be included in databases that the Berkshire Opioid Addiction Prevention Collaborative is working to build.

The organization is a partner in a four-county effort, the Opioid Affected Youth Initiative, which is hosted by the Franklin County Sheriff's Office.

Through a three-year grant, the group is hoping to develop and strengthen regional data systems serving young adults, Kimball said.

"This is certainly information that will go in there," she said. "We're going through all different kinds of data points that will help us as a region."

Haven Orecchio-Egresitz can be reached at horecchio@berkshireeagle.com, @HavenEagle on Twitter and 413-770-6977.


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