For the first time, the Drug Enforcement Agency’s database tracking prescription opioid pills across the nation has been made public, revealing Phelps County to be among the worst in the nation for pain pill distribution per capita. The database unveiled by the Washington Post tracked purchases and shipments of each individual pill of oxycodone and hydrocodone in the United States from 2006 to 2012. These records provide an unprecedented look into the prescription pain pills that fueled an opioid epidemic resulting in nearly 100,000 deaths during the seven years it tracked*. For Phelps County, this data sheds light on a dark matter.

Of the 76 billion pills distributed across the United States, 26,062,525 made their way to Phelps County- enough for 84.4 pills per person per year. Phelps County’s proportion of pills is not only higher than each surrounding county, but ties as the 101st highest out of 3,242 counties in the country with the 5th highest volume of pills in Missouri.

Rolla Chief of Police Sean Fagan has seen the effects of opioids in Phelps County first hand. The DEA revelations are only a glimpse into local law enforcement’s fight against opioids. “We are trying our best to battle with it, but it’s a battle. It’s an uphill battle,” Fagan said.

Chief Fagan and his officers encounter the opioid crisis at its most deadly. Legal prescription opioids such as oxycodone and hydrocodone are often stepping stones to the highly addictive, illegal narcotic heroin. This is where law enforcement are most able to intervene within the opioid crisis, but not easily.

“Up until about three years ago we were having a tremendous problem with opiods and the way we found out about it was because of all the overdoses we were having,” Fagan said. “A lot of people were dying.”

The Phelps County Police Department has managed to assuage these deaths after each officer began carrying Narcan, a drug capable of treating an overdose, three years ago. Chief Fagan shares that while this measure has decreased opioid related deaths in Phelps County, opioids are still pervasive and harmful to the community.

“I honestly don’t know why it’s so bad here. I came from St. Louis County and this is ten times worse than where I came from and I can’t tell you why,” Fagan said.

Chief Fagan is not alone in encountering the opioid crisis plaguing Phelps County. The 26,062,525 pills shipped into Phelps County between 2006 and 2012 wove their way through hospitals and pharmacies, patients and physicians, before reaching the hands of potential addicts.

Dr. Nathan Ratchford, Chief Medical Officer of Phelps Health and practicing OBGYN physician, sees opioids at the opposite end of the spectrum as Chief Fagan- newborn babies.*

“I don’t deliver babies any more, but I can tell you 15 years ago it was almost unheard of seeing a pregnant woman who was taking chronic narcotics when she got pregnant,” Ratchford said. “I bet if we were to go over to labor and delivery right now and look at the women who just had babies over there, I bet one or two of them has had some narcotic dependencey history.”

As CMO, Ratchford participates in administrative efforts within Phelps Health to combat the opioid crisis. While Ratchford shares numerous preventative measures enforced in recent years, he also acknowledges the limited capacity of one entity to combat such a widespread issue.

“The last thing that a health care system wants is to do something dangerous,” Ratchford said. “It’s unfortunate that we have this societal issue right now, but we don’t have the mechanism or the technology developed to the point to help take care of it. That’s frustrating.”

However telling, new data cannot stop the opioid crisis in Phelps County. Ratchford shares only a critical eye can begin to find the solutions needed to combat the fixedly complex nature of the opioid epidemic. “Sometimes we have to ask difficult and uncomfortable questions to fix these things,” Ratchford said.