This study takes advantage of transaction level data from the U.S. Drug Enforcement Administration\u27s (DEA) Automation of Reports and Consolidated Orders System (ARCOS) database made newly available under court order by The Washington Post in July 2019. This data details individual shipments of pharmaceutical opioid analgesics from wholesalers to retail distributors. Using the Enhanced 2-Step Floating Catchment Area (E2SFCA) method, this study calculated access to opioid morphine milligram equivalents (MME) per capita for census tracts in North Carolina and South Carolina during the year 2009. This study demonstrated that outlier volumes of opioid analgesics at individual pharmacies are not always co-located with census tracts that have access to outlier per capita opioid volumes. In addition, this study used 5-year average American Community Survey (ACS) data to identify distinct populations and compare their access to opioid analgesics using a k-medoids clustering algorithm. While opioid access for most clusters corresponded to previous research, a rural, socially vulnerable African American population in the Low Country of both states was identified with high access to opioid analgesics. This finding is contrary to previous research, indicating the need for further investigation
