aN OPIOID Pain Pill's Journey
Tracking the pill as it goes from the manufacturer to the RETAIL PHARMACY
The supply chain for prescription opioids begins with the manufacturer, includes distributors that channel pills from manufacturers to retail pharmacies, and ends with the retail pharmacy that dispenses pills to the public. Each participant—manufacturer, distributor, retail pharmacy—is legally and morally obligated to safeguard the supply chain, and shares responsibility for ensuring that only the right people receive prescription opioids. Recently filed lawsuits have alleged that, driven by the lure of massive profits, these companies have failed to uphold their obligations. Evidence demonstrates that participants in the supply chain have dramatically oversupplied the market and ignored specific legal duties to prevent the diversion of massive quantities of opioid drugs from the legitimate supply chain to illegitimate channels of distribution and use, fueling the opioid addiction and health crisis that is sweeping the country. Diversion can occur in multiple ways at any point in the supply chain.
Manufacturers
Manufacturers of prescription opioid drugs ship pills to a network of distributors across the country. Manufacturers are legally obligated to safeguard their inventories and ensure that they do not ship suspicious orders. Diversion can occur when manufacturers ship opioid orders of unusual size or unusual frequency, or opioid orders deviating substantially from a normal pattern, or when pills are lost or stolen from inventories or during transit from manufacturers to distributors.
Distributors
Distributors send opioid drugs to networks of retail pharmacies. As an integral part of the supply chain, distributors share responsibility for monitoring the prescription opioids they receive and ship, and they must report suspicious orders to the authorities. Diversion can occur when distributors fill retailers’ orders that are disproportionately large in comparison to the population served by the retailer or that deviate from a usual pattern, for example when orders are placed more frequently or in greater quantities than normal.

RetaiL PHARMACIES
Retail pharmacies are responsible for dispensing opioids only to patients with valid prescriptions. Diversion can occur when pharmacists fill prescriptions despite indications of diversion, such as when a single patient fills multiple prescriptions from different doctors at the same time or close in time, or travels a long distance from home or the prescriber’s office to fill a prescription, or when many persons who live long distances away fill their prescriptions at the same pharmacy.