The human toll of 5.6 billion pain pills for Florida -- Florida is coming to terms with its opioid crisis, but the price of inaction is high. (Tampa Bay Times Editorial)

Thanks to Palm Beach County State's Attorney Dave Aronberg, who was a special prosecutor on pill mills for former State Attorney General Pamela Jo Bondi, for his pioneering prosecution work against pill mills, 2011-2012. This sinister opioid pharmaceutical industry -- aided and abetted by advice from McKinsey, reported by Walt Bogdanich in The New York Times, -- requires the search hlisght of investigative reporting, civil lawsuits and criminal prosecution. As Justice Lous Dembitz Brandeis said, "Sunlight is the best disinfectant."

The human toll of 5.6 billion pain pills for Florida | Editorial

Florida is coming to terms with its opioid crisis, but the price of inaction is high.

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Between 2006 and 2012 5.6 billion opioid pain pills were distributed in Florida. [Times files]

Published Yesterday

The numbers are simply staggering. At the height of Florida’s opioid crisis, 5.6 billion prescription pain pills were supplied to Florida. Between addiction and overdoses, untold lives have been shattered because regulators, drug makers, pharmacies and the government let the disaster spiral out of control. Inaction has a heavy price, it is a hard lesson society needs to learn as those suffering from addictions rebuild their lives.

There were more than enough pain pills to go around in Tampa Bay. Between 2006 and 2012, 395 million pills were sent to Pinellas County pharmacies — enough to give every resident 61 pills a year. It was even worse in Hillsborough, with 565 million pills supplied — 67 per person per year. And according to court documents in a major federal opioid lawsuit, one Walgreens in Port Richey was ordering 3,271 bottles of oxycodone a month, this in a town of 2,831. Awakened to the crisis, doctors are now prescribing fewer opioids and finding other ways to offer patients relief from pain, state officials have set up data bases that allow far better monitoring of opioid abuse, and attorneys general, including Florida’s Ashley Moody, are going after pharmaceutical companies and suppliers in court. Provisional data from the Centers for Disease Control and Prevention shows that deaths from prescription pain killers at long last may have dropped significantly for the first time in a generation. There were 12,757 fatal overdoses of prescription painkillers nationally last year, compared with 14,495 in 2017.

In the first half of 2018, total drug-related deaths in Florida did decrease by 5 percent compared with the same period in 2017. But that better news comes too late for the thousands who died or whose lives have been wrecked. During those six months, Florida reported 1,841 deaths caused by opioids, with fentanyl being the single worst drug, causing 1,101 deaths.

It is hard to believe it came to this. For example, the disclosures about the Port Richey pharmacy were reported by the New York Times from court filings in an Ohio case and included this email in January 2011 to a colleague from the woman who had the task of reviewing suspicious drug orders: “I don’t know how they can even house this many bottles to be honest.” The Ohio lawsuit, scheduled for trial in October, is a major test that the presiding federal district judge hopes will persuade the sides to reach a national settlement.

Florida is doing some smarter things now. For one, Gov. Ron DeSantis and the Legislature have given the attorney general access to a state database that tracks prescriptions for serious drugs, from oxycodone to sleeping pills, with court approval. While keeping strong privacy protections, the database will allow Moody to pursue Florida’s potentially multi-billion dollar case against the nation’s largest drug makers and distributors, action that was begun in state court by her predecessor, Pam Bondi. For another, an emergency treatment called naloxone, which can reverse an opioid overdose in progress, is more widely in use and is saving lives. And new initiatives such as the just-formed West Central Florida Mental Wellness Coalition have set one of its missions to combat substance abuse issues, which affects one 1 in 12 residents. This is key, as too many addicts lacking treatment have shifted from oxycodone and hydrocodone pills to heroin or fentanyl.

These efforts are all worthy. Still, they are a reminder that it’s far better to prevent a problem than to have to cure it, and inaction can carry a heavy price.

Eye-popping pill numbers

Pills per person per year (between 2006 and 2012)

67 in Hillsborough (565,124,893 prescription pain pills)

61 in Pinellas (394,843,803 pills)

61 in Pasco (195,414,137 pills)

26,253,800 is how many pills were received by a single pharmacy in Tampa, the second-highest number in the state.

Source: The Washington Post gained access to the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System, known as ARCOS, as the result of a court order. The Post and HD Media, which publishes the Charleston Gazette-Mail in West Virginia, waged a year-long legal battle for access to the database, which the government and the drug industry had sought to keep secret. They are publicly sharing this information, which includes these county-by-county breakdowns.