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CDC: Opioid prescriptions 87% more likely in rural areas
Residents of the most rural locations in the United States were nearly 90% more likely to receive an opioid prescription than residents of large central metropolitan locations during a recent 3-year period, according to data recently published in MMWR.
Macarena C. García, DrPH, of the CDC’s Center for Surveillance, Epidemiology and Laboratory Services, and colleagues retrospectively reviewed electronic health record data from 31,422 primary health care providers and approximately 17 million patients from Jan. 5, 2014, through March 11, 2017.
They found during that time span, residents of the most rural counties were 87% more likely to receive an opioid prescription than residents of large central metropolitan ones. Overall, 9.6% of residents in the most rural counties received opioid prescriptions vs. 5.2% of residents in large central metropolitan ones.
According to researchers, prescription drug use and misuse at an earlier age, higher occurrences of chronic pain and conditions associated with pain, limited access to medication-assisted treatment facilities and alternative therapies, and inconsistencies in the implementation of state laws and state-run prescription drug monitoring programs are all more prevalent in rural areas, making these locations vulnerable to more opioid prescriptions.
Some findings suggest the opioid epidemic rates are moving in a more positive direction.
“Whereas the prescribing rate increased from January 2014 through January 2015 in both micropolitan and noncore counties, those trends halted, and rates became flat or declined through mid-March 2016. Trends in all other urban-rural categories were flat or decreasing over the same two periods. The odds of a patient receiving an opioid prescription decreased in all urban-rural county groups after the March 2016 publication of the CDC Guideline [for Prescribing Opioids for Chronic Pain],” García and colleagues wrote.
The findings also suggest a way to leverage EHRs to address the opioid crisis, according to researchers.
“This study demonstrates that data from EHRs can effectively supplement traditional surveillance methods for monitoring trends in opioid prescribing and other areas of public health importance. The lag between the collection of the data and this analysis could potentially be reduced to a matter of weeks with optimized workflows,” they wrote.
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Disclosures: The authors report no relevant financial disclosures.