Billions of pills. Thousands of deaths.

According to a Drug Enforcement Administration database published by the Washington Post, nearly 3.4 billion prescription pain pills were supplied to Ohio from 2006 to 2012 — millions of which were prescribed in Portage and Summit counties alone. 

Overprescription of opiate pills is widely believed to have partly led to the current Ohio drug crisis.

"We’ve always had drug addiction, alcohol problems, but when opiates got onto the scene this last decade, the introduction of fentanyl, that’s when we really started to see the rapid loss of life," said Karyn Kravetz, spokesperson for the Mental Health and Recovery Board of Portage County.

According to the National Institute on Drug Abuse, about 80% of the people who became addicted to heroin between 2002 and 2012 first began misusing opiates.

The DEA information — released as part of the largest civil action in U.S. history — tracks shipments of oxycodone and hydrocodone pills, which account for three-quarters of the total opioid pill shipments to pharmacies. Distributors sent 76 billion opioid pills throughout the nation from 2006 to 2012, far more than previously known.

But pills were not evenly prescribed across Ohio, according to the data.

Far more pills per person were prescribed in rural counties in southern Ohio, such as Gallia County and Jackson County, than in northeastern Ohio counties. Jackson County got about 106 pills for every resident per year; Gallia County received 88 pills per person per year.

About 28 pills per person per year were prescribed in Portage County between 2006 and 2012, according to the data. Many of those pills were sent to Ravenna pharmacies: Prescriptions for more than 7 million pills were filled through Giant Eagle Pharmacy in Ravenna, CVS in Ravenna and Walgreens in Kent. 

Of the three, Giant Eagle Pharmacy in Ravenna filled the most prescriptions for opioids in that period: 2,810,760 pills.

"We recognize the severity of the opioid crisis affecting so many across our communities, and we are committed to doing our part to improve the health and well-being of those we serve," Giant Eagle spokesman Dan Donovan said in an emailed statement. 

Walgreens was the top distributer of opioids in that time period to Portage County: 5,398,720 pills.

"Walgreens has not distributed prescription controlled substances since 2014 and before that time only distributed to our chain of pharmacies," said Phil Caruso, a spokesman for Walgreens media relations, in an emailed statement. "Walgreens has been an industry leader in combatting this crisis in the communities where our pharmacists live and work."

CVS did not reply to the Record-Courier’s request for comment. 

The amount of opioids flooding Ohio has had a particularly hard effect on law enforcement, who deal with arrests and jailing suspects of drug use. 

"It goes without saying it’s really affected law enforcement everywhere," said Portage County Sheriff David Doak. "It’s really affected jail overcrowding, the amount of health problems in the jail, the list goes on."

A total of 75 people died of drug overdoses between 2006 and 2012 in Portage County, according to data from the Ohio Department of Health. In 2017, the most recent year the Ohio Department of Health has published data, 39 people died from drug overdoses.

Summit County had far more pills prescribed between 2006 and 2012, according to the data: an average of 44 pills per person for a total of 168,170,319 pills.

Many of those prescriptions were filled through New Choice Pharmacy in Cuyahoga Falls, which dispensed 5,146,270 pills in the time period, the most within Summit County. Western Reserve Hospital, which owns the pharmacy, did not return a request for comment.

A total of 432 people died in Summit County from drug overdoses between 2006 and 2012, according to Ohio Department of Public Health data.

Gerry Craig, executive director executive director of the Summit Alcohol, Drug Addiction & Mental Health Services Board said the opiate problem sort of creeped up on the office in the mid-2000s.

"The only way we really knew what was going on was the increased need for services," Craig said.

There still is a lot of stigma around addiction, he said, but since 2012, the stigma has lessened and it is more likely someone will seek help.

The opioid crisis’s effect on children within Summit County has also been terrible, he said.

"It’s heart-wrenching when you see the impact this has had on kids, and kids are vulnerable to this and it affects their whole life’s trajectory," Craig said. "It’s something that gets lost when we talk about people who have been in recovery."

Dr. Mark Hurst, medical director of the Ohio Department of Health, said there is hope amid the numbers, as progress has been made in addressing drug prescribing and addiction.

He said prescribing guidelines have been established in Ohio for emergency departments, the treatment of acute pain, and the treatment of chronic pain. And over the past several years, he added, formal rules have been established to allow enforcement of these guidelines.

Hurst added that the changes have been followed by significant drops in prescription doses and prescription drug overdose deaths. Estimates from the federal Centers for Disease Control and Prevention indicate that Ohio had 4,002 overdose deaths last year, 1,153 fewer than the year before and one of the biggest drops in the country, Hurst said.

"Our job is not done, and when we see improvement in the numbers, we can’t say it is time for us to press pause," he said. "We need keep to keep our feet on the gas, keep doing this to turn things around."

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Contact reporter Eileen McClory at 330-298-1128, or @Eileen_McClory. The Columbus Dispatch contributed reporting to this story.