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Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016.
MMWR Surveill Summ. 2020 Jan 31; 69(1):1-14.MS

Abstract

PROBLEM/CONDITION

In 2017, a total of 70,237 persons in the United States died from a drug overdose, and 67.8% of these deaths involved an opioid. Historically, the opioid overdose epidemic in the United States has been closely associated with a parallel increase in opioid prescribing and with widespread misuse of these medications. National and state policy makers have introduced multiple measures to attempt to assess and control the opioid overdose epidemic since 2010, including improvements in surveillance systems.

PERIOD COVERED

2010-2016 DESCRIPTION OF SYSTEM: The Prescription Behavior Surveillance System (PBSS) was created in 2011. Its goal was to track rates of prescribing of controlled substances and possible misuse of such drugs using data from selected state prescription drug monitoring programs (PDMP). PBSS data measure prescribing behaviors for prescription opioids using multiple measures calculated from PDMP data including 1) opioid prescribing, 2) average daily opioid dosage, 3) proportion of patients with daily opioid dosages ≥90 morphine milligram equivalents, 4) overlapping opioid prescriptions, 5) overlapping opioid and benzodiazepine prescriptions, and 6) multiple-provider episodes. For this analysis, PBSS data were available for 2010-2016 from 11 states representing approximately 38.0% of the U.S.

POPULATION

Average quarterly percent changes (AQPC) in the rates of opioid prescribing and possible opioid misuse measures were calculated for each state.

RESULTS AND INTERPRETATION

Opioid prescribing rates declined in all 11 states during 2010-2016 (range: 14.9% to 33.0%). Daily dosage declined least (AQPC: -0.4%) in Idaho and Maine, and most (AQPC: -1.6%) in Florida. The percentage of patients with high daily dosage had AQPCs ranging from -0.4% in Idaho to -2.3% in Louisiana. Multiple-provider episode rates declined by at least 62% in the seven states with available data. Variations in trends across the 11 states might reflect differences in state policies and possible differential effects of similar policies.

PUBLIC HEALTH ACTIONS

Use of PDMP data from individual states enables a more detailed examination of trends in opioid prescribing behaviors and indicators of possible misuse than is feasible with national commercially available prescription data. Comparison of opioid prescribing trends among states can be used to monitor the temporal association of national or state policy interventions and might help public health policymakers recognize changes in the use or possible misuse of controlled prescription drugs over time and allow for prompt intervention through amended or new opioid-related policies.

Authors+Show Affiliations

Institute for Behavioral Health, Brandeis University, Waltham, MA.Institute for Behavioral Health, Brandeis University, Waltham, MA.Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC.Institute for Behavioral Health, Brandeis University, Waltham, MA.Certified Technical Experts, Inc., Montgomery, AL.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31999681

Citation

Strickler, Gail K., et al. "Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016." Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002), vol. 69, no. 1, 2020, pp. 1-14.
Strickler GK, Kreiner PW, Halpin JF, et al. Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016. MMWR Surveill Summ. 2020;69(1):1-14.
Strickler, G. K., Kreiner, P. W., Halpin, J. F., Doyle, E., & Paulozzi, L. J. (2020). Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002), 69(1), 1-14. https://doi.org/10.15585/mmwr.ss6901a1
Strickler GK, et al. Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016. MMWR Surveill Summ. 2020 Jan 31;69(1):1-14. PubMed PMID: 31999681.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opioid Prescribing Behaviors - Prescription Behavior Surveillance System, 11 States, 2010-2016. AU - Strickler,Gail K, AU - Kreiner,Peter W, AU - Halpin,John F, AU - Doyle,Erin, AU - Paulozzi,Leonard J, Y1 - 2020/01/31/ PY - 2020/1/31/entrez PY - 2020/1/31/pubmed PY - 2020/1/31/medline SP - 1 EP - 14 JF - Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) JO - MMWR Surveill Summ VL - 69 IS - 1 N2 - PROBLEM/CONDITION: In 2017, a total of 70,237 persons in the United States died from a drug overdose, and 67.8% of these deaths involved an opioid. Historically, the opioid overdose epidemic in the United States has been closely associated with a parallel increase in opioid prescribing and with widespread misuse of these medications. National and state policy makers have introduced multiple measures to attempt to assess and control the opioid overdose epidemic since 2010, including improvements in surveillance systems. PERIOD COVERED: 2010-2016 DESCRIPTION OF SYSTEM: The Prescription Behavior Surveillance System (PBSS) was created in 2011. Its goal was to track rates of prescribing of controlled substances and possible misuse of such drugs using data from selected state prescription drug monitoring programs (PDMP). PBSS data measure prescribing behaviors for prescription opioids using multiple measures calculated from PDMP data including 1) opioid prescribing, 2) average daily opioid dosage, 3) proportion of patients with daily opioid dosages ≥90 morphine milligram equivalents, 4) overlapping opioid prescriptions, 5) overlapping opioid and benzodiazepine prescriptions, and 6) multiple-provider episodes. For this analysis, PBSS data were available for 2010-2016 from 11 states representing approximately 38.0% of the U.S. POPULATION: Average quarterly percent changes (AQPC) in the rates of opioid prescribing and possible opioid misuse measures were calculated for each state. RESULTS AND INTERPRETATION: Opioid prescribing rates declined in all 11 states during 2010-2016 (range: 14.9% to 33.0%). Daily dosage declined least (AQPC: -0.4%) in Idaho and Maine, and most (AQPC: -1.6%) in Florida. The percentage of patients with high daily dosage had AQPCs ranging from -0.4% in Idaho to -2.3% in Louisiana. Multiple-provider episode rates declined by at least 62% in the seven states with available data. Variations in trends across the 11 states might reflect differences in state policies and possible differential effects of similar policies. PUBLIC HEALTH ACTIONS: Use of PDMP data from individual states enables a more detailed examination of trends in opioid prescribing behaviors and indicators of possible misuse than is feasible with national commercially available prescription data. Comparison of opioid prescribing trends among states can be used to monitor the temporal association of national or state policy interventions and might help public health policymakers recognize changes in the use or possible misuse of controlled prescription drugs over time and allow for prompt intervention through amended or new opioid-related policies. SN - 1545-8636 UR - https://www.unboundmedicine.com/medline/citation/31999681/Opioid_Prescribing_Behaviors___Prescription_Behavior_Surveillance_System_11_States_2010_2016_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31999681/ DB - PRIME DP - Unbound Medicine ER -
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