Opioid Prescriptions Decrease But Still Elevated Compared To 20 Years Ago

MedicalResearch.com Interview with:

Deborah Dowell, MD, MPH Chief Medical Officer, Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention

Dr. Dowell

Deborah Dowell, MD, MPH
Chief Medical Officer, Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention 

MedicalResearch.com: What is the background for this study?

Response: CDC analyzed retail prescription data from QuintilesIMS which provides estimates of the number of opioid prescriptions dispensed in the United States from approximately 59,000 pharmacies, representing 88% of prescriptions in the United States. CDC assessed opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015.

MedicalResearch.com: What are the main findings?

Response: Although amounts of opioids prescribed have decreased in some areas of the United States since 2010, amounts prescribed remain substantially elevated compared to years prior to 2000, putting the U.S. population, especially those in high prescribing counties, at continued risk for opioid use disorder and overdose.

  • Changes at the national level were analyzed from 2006 to 2015:

o   Morphine milligram equivalents (MME) per capita: The amounts of opioids prescribed in the United States peaked at 782 MME per person in 2010 and decreased to 640 MME in 2015. Despite reductions, the amount of opioids prescribed remains three times higher than in 1999.

o   Measures of prescribing:

  • Opioid prescribing rates: increased from 2006 to 2010, were constant from 2010 to 2012, and then decreased by 13.1% to 70.6 prescriptions per 100 persons from 2012 to 2015.
  • High-dose prescribing rates: remained stable from 2006 to 2010 and then declined by 41.4% (11.4 per 100 persons to 6.7 per 100 persons) from 2010 to 2015.
  • Prescribing rates by days supply (≥30 days): increased 58.9% from 2006 to 2012 and leveled off from 2012 to 2016.
  • Prescribing rates by days supply (<30 days): remained stable from 2006 to 2012, and decreased 20.2% from 2012 to 2016.
  • Average daily MME per prescription: remained stable from 2006 to 2010, and then decreased 16.9% from 2010 to 2015.
  • Average days supply per prescription: increased 33.0% from 13.3 days in 2006 to 17.7 days in 2015.
  • Changes at the county level were analyzed for 2010 and 2015:

o   Overall per capita amounts prescribed decreased in half of counties from 2010 to 2015.

o   Average per capita amounts prescribed in the top-prescribing quartile of counties were six times the amounts prescribed in the lowest-prescribing quartile.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: The amount of opioids being prescribed is still too high, and it places Americans at risk for opioid use disorder (addiction), overdose, and death.

  • Changes in annual prescribing measures from 2006 to 2015 hold promise that more can be done to improve prescribing practices. The Guideline can be used to inform healthcare providers, health systems, states, and insurers to reduce overprescribing and improve care for all Americans.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Our analysis examined prescribing trends before release of the Guideline in March 2016.

Future research will examine the impact of the Guideline on prescribing trends.

MedicalResearch.com: Is there anything else you would like to add?

Response: The findings provide critical new information to help better inform prescribers of the risks of overprescribing of opioids in the United States.

  • With opioid misuse and overdose impacting communities and families across the nation, everyone can help fight this issue and become part of the solution.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Schuchat A, Houry D, Guy GP. New Data on Opioid Use and Prescribing in the United States. JAMA. Published online July 06, 2017. doi:10.1001/jama.2017.8913

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on July 11, 2017 by Marie Benz MD FAAD