LAKE STEVENS — Off Highway 9 in Lake Stevens and across from the Haggen’s grocery sits a Bartell Drugs. It has the same red-and-white signs as any other. But what sets this drugstore apart is just that — drugs.
Between 2006 and 2012, the store sold more than five million prescription opioids, more than any other pharmacy in the county and 21st statewide. That’s enough to give each Lake Stevens resident 26 pills per year.
Then take I-5 north to Arlington. Off Smokey Point Boulevard, you’ll find Rite Aid, which ranked second in the number of opioids prescribed countywide. The pharmacy sold more than 5 million pills in the seven-year period. The city’s population is less than 20,000.
Then travel east to Granite Falls. Local pharmacy Pharm-A-Save filled orders for 3.5 million opioid pills in the same span. For the town of about 3,300, the single distributor provided an average of 150 pills a year per person.
All of this is according to U.S. Drug Enforcement Administration data analyzed by The Washington Post. The Post made the data available in mid-July after gaining access to the DEA’s Automation of Reports and Consolidated Orders System, known as ARCOS. The Post and HD Media, which publishes the Charleston Gazette-Mail in West Virginia, fought in court for a year to get access to the database.
In total, more than 220 million prescription opioids were sold in Snohomish County in the seven-year period. More than half the pills were manufactured by SpecGx, a UK-based generic drug maker.
The pills flooded into the county at a time when the number of opioid-related overdose deaths nationwide soared, ravaging communities large and small. While the numbers continue to rise in some regions of the country, Washington is beginning to see a decline in both the number of opioid prescriptions and opioid-related deaths, according to state Department of Health data.
Bartell Drugs Vice President of Pharmacies Billy Chau said a lot has changed since 2012, including the implementation of a state program designed to track the prescription and use of opioid-based drugs, and make that information available to health care providers, practitioners and law enforcement. It’s meant to make sure doctors and pharmacists are on the same page when giving and filling prescriptions and to prevent practices like doctor shopping, where patients receive prescriptions from multiple doctors. The tool, authorized by the Legislature in 2007, went active in January 2012.
“Before the launch of the Prescriptions Monitoring Program, we didn’t know if a patient was filling their prescription somewhere else,” Chau said. “It’s incumbent on us to vet out whether these are legitimate prescriptions and if these are being given out for legitimate reasons. We want that collaboration to treat our patients as best as we can.”
Wisconsin, Nebraska and Missouri are the only states without a similar drug-monitoring program.
Walgreens, which operates 10 stores in Snohomish County, also ranked among top providers of opioids with a branch in Lynnwood and another in Everett ranking third and fifth in the numbers of pills dispensed.
A statement from the company said it’s followed all legal requirements to sell the prescription opioids legally.
Statewide, five of the top 10 pharmacies filling opioid prescriptions were Kaiser Permanente branches. Kaiser Permanente operates as both doctor and pharmacist for its patients. Spokeswoman Julie Popper said the company has 700,000 patients in Washington and pill numbers don’t reflect the size of their operation.
The company’s Everett medical center dispensed the fourth highest number of opioids countywide between 2006 and 2012. Since then, the company has seen a 52 percent decrease in high-dosage opioid prescriptions in the state, Popper said. The number of opioid prescriptions filled by Kaiser in Everett has dropped by 32 percent since January.
Popper also cited the Everett branch’s in-office treatment program. Those who struggle with opioid addiction are paired with a nurse who navigates the services each patient needs. Everett is the only Kaiser facility in the state offering the program.
Chau said manufacturers, doctors and pharmacists all played roles in the influx of pills.
“If we’re looking at an opioid prescription for somebody that is just starting on a chronic pain-management program, and if we felt the dosage was too high, we’d contact the doctor and ask why the patient needs that dose,” he said. “If there is a concern and the doctor was not aware the prescription was too strong or too much, there’s oftentimes a change when it’s warranted. We’re the medications experts and they’re the diagnosis experts.”
In January 2017, the city of Everett filed a civil lawsuit against Purdue Pharma for allowing OxyContin to be funneled through the black market, causing what it described as an opioid crisis in Everett. Others followed, including Snohomish County government earlier this year.
Opioid pills sold per capita
The average number of opioid pills sold per resident between 2006 and 2012. Based on data from the U.S. Drug Enforcement Administration, the number of pills sold in each city was averaged to an annual basis and divided by the city’s 2012 population.