In her third report on opioid abuse in the U.S., Sen. Claire McCaskill (D-Mo.) recommends giving the DEA more authority to penalize pharmaceutical distributors for failing to meet reporting obligations and cites widely varying reporting numbers of big distributors as a sign of waning DEA enforcement.

The report revealed that the “big three” U.S. distributors — McKesson, AmerisourceBergen and Cardinal Health, which account for 90 percent of U.S. drug distribution revenue — together shipped 1.6 billion doses of opioids into Missouri from 2012 to 2017, around 260 doses per resident.

“The opioid crisis these pills have fueled is a failure of policy and oversight by the government and a failure … on the part of many pharmaceutical companies and distributors,” McCaskill said.