A large amount of data from the U.S. Drug Enforcement Agency's monitoring system has come to light this week during the midst of several legal proceedings against pharmaceutical manufacturers.
The Washington Post, who had argued for the release of the data, published a database of all of the information provided to them. But the data paints a picture of the worst seven years of the opioid epidemic in Ohio.
According to the DEA's data, more than three billion opioid pills were distributed in Ohio between 2006 to 2012. Overall, the Ohio State Board of Pharmacy says that amounted to nearly 70 pills per person.
In the Valley, Trumbull County saw 54 pills per person, Mahoning County, 44.9 pills per person, and in Columbiana 36 pills.
The data set breaks down the information into groups, naming the McKesson Corporation as the largest distributor of opioids to Mahoning, Trumbull, and Columbiana counties.
But it takes it a step farther, breaking down how each pharmacy sold many individual pills from 2006-2012.
In Trumbull County, the highest seller of opioids was Franklin Pharmacy in Warren, having sold 6.7 million pills in six years.
In Mahoning County, Brown's Drug Store sold 7.6 million pills.
And in Columbiana County Herche Bloor sold more than 3 million pills.
While all of the highest-selling pharmacies in the area are family-owned, "mom and pop" type stores, the Ohio Board of Pharmacy says that may not be as unusual as it looks.
The Board says that smaller shops can sometimes have more significant numbers of sales because they may be situated in an area where other pharmacies aren't, or closer to doctors, hospitals, and care centers than larger retailers.
Also, the smaller pharmacies tend to cater to an older demographic and take insurance providers that larger pharmacies may not, according to the Board of Pharmacy.
While at first glance the numbers may appear shocking, Mahoning County Mental Health and Recovery Board Executive Director Duane Piccirilli said they're a reflection of the past.
"Well that's when people were using the pills, doctors were prescribing the pills, people were storing up with pills. But then we started seeing the overdoses, and that's when the Ohio Department of Mental Health, and all the treatment providers, and the boards, started saying wait a minute, we have to look at this, we have to see whats going on. A lot of the prevention programs started, a lot of the research happened," Piccirilli explained.
Following 2012, Piccirilli said that the Valley, and the state as a whole, began seeing decreases in the number of opioid pills being sold and prescribed.
According to data from the Ohio Automated Rx Reporting System, the number of opioids being prescribed in Trumbull County had gone down to 59.9 per person, in Mahoning to 47.7 per person, and in Columbiana 42.9 per person- a stark decrease from where they had been in 2012.
Piccirilli also says that while the mom and pop shops may have sold the most pills during that time, it's not necessarily an indicator of bad behavior.
"The numbers appear high. But when you look there was one store in Boardman but several in Austintown, and so those might have gone together," he said.
Also, some shops, like Browns, have gone to bat to help officials stop the epidemic.
"These smaller pharmacies like Browns, work very closely with our agencies, and partner with our agencies. Some of them will run credit on our consumers who are being monitored by case managers, and nothing inappropriate is happening, but they're partnering with them," Piccirilli explained.
Even though the data comes from 2006 to 2012, Piccirilli says some lessons should be taken from it into the future.
"I think we need to learn from this experience and monitor other medications. Because people are very fast to take a pill to get better, and we have to step back and see what medication we're taking, how they interact with other medication, and if there are other treatment modalities that we can use other than pills," he explained.
"I think it's a lesson learned. The alarm was sounded, and once the alarm was sounded we saw the reduction, and that's why we really have to do a better job on sounding the alarm for something that may be coming down the road that we don't even know about," Piccirilli said.
More information about the data, including additional counties and a breakdown of every pharmacy's sales can be found in the Washington Post database.