According to the Centers for Disease Control and Prevention (CDC), despite reductions in certain parts of the country, the amount of opioids being prescribed remains high compared to levels in 1999, with variations mostly seen at the county level. 

Between 1999–2010, there was a big increase in the number of prescription opioid-related deaths in the United States along with an increased amount of opioids prescriptions. The CDC sought to assess prescribing patterns between 2006–2015 at the national- and county-level. A team of researchers reviewed prescription data from QuintilesIMS analyzing the rates, amounts, doses, and treatment duration associated with opioid prescribing. 

The analysis showed an increase in annual opioid prescribing rates from 72.4 to 81.2 prescriptions per 100 persons from 2006–2010; this remained constant until 2012 then dropped to 70.6 prescriptions per 100 persons from 2012–2015. Rates of high-dose opioid prescribing remained constant from 2006–2010 then dropped from 11.4 to 6.7 prescriptions per 100 persons in 2015.

The highest amounts of were reported in 2010 at 782 morphine milligram equivalents (MME) per capita, decreasing to 640 MME per capita in 2015. Although there was a substantial reduction, the amount of opioids prescribed in 2015 was still approximately three times higher than the amount prescribed in 1999 (180 MME per capita) and almost four times higher than the amount distributed in Europe.  

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At the county-level, factors linked to higher amount of prescribed opioids included a larger percentage of non-Hispanic whites, a greater prevalence of diabetes and arthritis, micropolitan status (eg, town/city, non-metro), higher rates of unemployment, and higher Medicaid enrollment.

Study authors attributed the decreased average daily MME per prescription after 2010 to national guidelines that defined high-dose opioid prescribing as >200 MME per day. Also, the decreased rate of opioid prescribing across the country and in many counties was attributed to the “growing awareness among clinicians and patients of the risks associated with opioids.” 

The report recommends clinicians consider the benefits and risks when prescribing opioids outside of palliative care, to follow evidence-based guidelines, and to consider non-opioid options for chronic pain management. 

“Changes in opioid prescribing can save lives. The findings of this report demonstrate that substantial changes are possible and that more are needed,” concluded the authors. 

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