Opioid Prescribing: Where you live matters

The amount of opioids prescribed in the US peaked in 2010 and then decreased each year through 2015. However, prescribing remains high and vary widely from county to county. Healthcare providers began using opioids in the late 1990s to treat chronic pain (not related to cancer), such as arthritis and back pain. As this continued, more opioid prescriptions were written, for more days per prescription, in higher doses. Taking opioids for longer periods of time or in higher doses increases the risk of addiction, overdose, and death. In 2015, six times more opioids per resident were dispensed in the highest-prescribing counties than in the lowest-prescribing counties. County-level characteristics, such as rural versus urban, income level, and demographics, only explained about a third of the differences. This suggests that people receive different care depending on where they live.  Healthcare providers have an important role in offering safer and more effective pain treatment.

Healthcare providers can:

• Follow the CDC Guideline for Prescribing Opioids for Chronic Pain, which includes recommendations such as:
  • Use opioids only when benefits are likely to outweigh risks.
  • Start with the lowest effective dose of immediate-release opioids.  For acute pain, prescribe only the number of days that the pain is expected to be severe enough to require opioids.
  • Reassess benefits and risks if considering dose increases.
• Use state-based prescription drug monitoring programs (PDMPs) which help identify patients at risk of addiction or overdose.