Two of Maine’s top three dispensers of opioid painkillers were pharmacies in Bangor between 2006 and 2012. During those early days of the state’s burgeoning opioid crisis, those pharmacies provided millions of the pills produced by out-of-state companies that doctors had prescribed to their patients.
That’s according to newly released federal data compiled by the Washington Post that offers a glimpse into the way that Penobscot County became a hotbed of pain pill prescribing during that time. Those data also showed that Penobscot County saw a higher average number of pain pills handed out per person each year — 56 — than any county in New England between 2006 and 2012.
The former Miller Drug pharmacy in Bangor was Maine’s top dispenser of oxycodone and hydrocodone pills, providing 4.5 million of the pills at one of its locations between 2006 and 2012 — a number that would grow by several million if other Miller Drug locations were considered.
It was followed in second and third place by Hannaford locations in Ellsworth and Bangor, respectively, which provided a combined 8 million pills.
The fact that pharmacies in Bangor dispensed the highest numbers of pills is a reflection of the volume of opioid prescriptions Bangor-area doctors wrote, the market share of those particular pharmacies and the kinds of customers those pharmacies served.
“My guess is that there was nothing unique about the pharmacies,” said Dr. Noah Nesin, vice president of medical affairs at Penobscot Community Health Care.
Physicians must prescribe medications to their patients, he said, and Hannaford and Miller Drug just happened to be among the largest pharmacies in the region at that time that could fill the prescriptions.
Providers have since cut down on their prescription of opioid painkillers amid a crackdown from state and federal authorities, but as heroin and fentanyl took their places, drug overdose deaths steadily climbed in Maine through 2018.
“Even until 2014, 2016, there was pretty widespread overprescription, especially focused in the Bangor region,” Nesin said. “That’s just proven by the data. It’s not a judgment on my part.”
There’s a lack of research into why health care providers in some regions have prescribed more pain pills than others, according to Nesin. But one potential explanation, based on what’s happened in other parts of the country, is marketing from pharmaceutical companies that has targeted prescribers in places with working-class populations, he said. Those populations — such as paper mill workers — are more susceptible to injuries and chronic pain.
The time period for which the federal opioid pill distribution data are available covered a time of transition for Miller Drug, which started as a pharmacy in 1957 at its State Street location in Bangor.
In 2010, Miller Drug merged with the hospital network that was then called Eastern Maine Healthcare Systems, and all of the system’s in-house pharmacies took the Miller Drug name. It was recently renamed Northern Light Pharmacy to reflect the health care system’s new brand.
Miller Drug has provided medications for several different patient groups that overall have a higher need for opioid painkillers, said Director Matthew Marston. For example, it’s served multiple hospice agencies and long-term care facilities. Unlike some retail pharmacies, it has also been open every day of the year and serves people who have broken bones or suffered other medical emergencies who may require immediate pain relief.
He also said that Northern Light Pharmacy has been diligent about checking the history of its patients to make sure they are not at risk of abusing medications, going further than the scrutiny that is required in state law.
Eric Blom, a spokesman for Hannaford, said it is important to recognize that Hannaford is one of the largest pharmacies in the state.
“We take seriously our commitment to work with prescribers in the proper prescribing and dispensing of controlled substances,” he said. “Hannaford’s operational practices and compliance guidelines have reflected this responsibility, and we continue to work with our pharmacists to ensure stringent guidelines and practices on these matters to help identify and cease abuse.”