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Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015.
MMWR Morb Mortal Wkly Rep. 2017 Jul 07; 66(26):697-704.MM

Abstract

BACKGROUND

Prescription opioid-related overdose deaths increased sharply during 1999-2010 in the United States in parallel with increased opioid prescribing. CDC assessed changes in national-level and county-level opioid prescribing during 2006-2015.

METHODS

CDC analyzed retail prescription data from QuintilesIMS to assess 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.

RESULTS

The amount of opioids prescribed in the United States peaked at 782 morphine milligram equivalents (MME) per capita in 2010 and then decreased to 640 MME per capita in 2015. Despite significant decreases, the amount of opioids prescribed in 2015 remained approximately three times as high as in 1999 and varied substantially across the country. County-level factors associated with higher amounts of prescribed opioids include a larger percentage of non-Hispanic whites; a higher prevalence of diabetes and arthritis; micropolitan status (i.e., town/city; nonmetro); and higher unemployment and Medicaid enrollment.

CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE

Despite reductions in opioid prescribing in some parts of the country, the amount of opioids prescribed remains high relative to 1999 levels and varies substantially at the county-level. Given associations between opioid prescribing, opioid use disorder, and overdose rates, health care providers should carefully weigh the benefits and risks when prescribing opioids outside of end-of-life care, follow evidence-based guidelines, such as CDC's Guideline for Prescribing Opioids for Chronic Pain, and consider nonopioid therapy for chronic pain treatment. State and local jurisdictions can use these findings combined with Prescription Drug Monitoring Program data to identify areas with prescribing patterns that place patients at risk for opioid use disorder and overdose and to target interventions with prescribers based on opioid prescribing guidelines.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

28683056

Citation

Guy, Gery P., et al. "Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015." MMWR. Morbidity and Mortality Weekly Report, vol. 66, no. 26, 2017, pp. 697-704.
Guy GP, Zhang K, Bohm MK, et al. Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017;66(26):697-704.
Guy, G. P., Zhang, K., Bohm, M. K., Losby, J., Lewis, B., Young, R., Murphy, L. B., & Dowell, D. (2017). Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015. MMWR. Morbidity and Mortality Weekly Report, 66(26), 697-704. https://doi.org/10.15585/mmwr.mm6626a4
Guy GP, et al. Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017 Jul 7;66(26):697-704. PubMed PMID: 28683056.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015. AU - Guy,Gery P,Jr AU - Zhang,Kun, AU - Bohm,Michele K, AU - Losby,Jan, AU - Lewis,Brian, AU - Young,Randall, AU - Murphy,Louise B, AU - Dowell,Deborah, Y1 - 2017/07/07/ PY - 2017/7/7/entrez PY - 2017/7/7/pubmed PY - 2017/7/14/medline SP - 697 EP - 704 JF - MMWR. Morbidity and mortality weekly report JO - MMWR Morb. Mortal. Wkly. Rep. VL - 66 IS - 26 N2 - BACKGROUND: Prescription opioid-related overdose deaths increased sharply during 1999-2010 in the United States in parallel with increased opioid prescribing. CDC assessed changes in national-level and county-level opioid prescribing during 2006-2015. METHODS: CDC analyzed retail prescription data from QuintilesIMS to assess 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. RESULTS: The amount of opioids prescribed in the United States peaked at 782 morphine milligram equivalents (MME) per capita in 2010 and then decreased to 640 MME per capita in 2015. Despite significant decreases, the amount of opioids prescribed in 2015 remained approximately three times as high as in 1999 and varied substantially across the country. County-level factors associated with higher amounts of prescribed opioids include a larger percentage of non-Hispanic whites; a higher prevalence of diabetes and arthritis; micropolitan status (i.e., town/city; nonmetro); and higher unemployment and Medicaid enrollment. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Despite reductions in opioid prescribing in some parts of the country, the amount of opioids prescribed remains high relative to 1999 levels and varies substantially at the county-level. Given associations between opioid prescribing, opioid use disorder, and overdose rates, health care providers should carefully weigh the benefits and risks when prescribing opioids outside of end-of-life care, follow evidence-based guidelines, such as CDC's Guideline for Prescribing Opioids for Chronic Pain, and consider nonopioid therapy for chronic pain treatment. State and local jurisdictions can use these findings combined with Prescription Drug Monitoring Program data to identify areas with prescribing patterns that place patients at risk for opioid use disorder and overdose and to target interventions with prescribers based on opioid prescribing guidelines. SN - 1545-861X UR - https://www.unboundmedicine.com/medline/citation/28683056/Vital_Signs:_Changes_in_Opioid_Prescribing_in_the_United_States_2006_2015_ L2 - https://doi.org/10.15585/mmwr.mm6626a4 DB - PRIME DP - Unbound Medicine ER -