This article is more than 5 years old. Information may no longer be current.

Number of opioids prescribed falls as long-term prescriptions rise

Over a period of 12 years, the number of opioids prescribed per person decreased, whereas the prescribing rate for long-term prescriptions increased, according to findings published in JAMA Network Open.

These data may help inform the creation of state-specific laws, policies, communications and interventions regarding opioid prescribing, according to the researchers.

“Large variation among states has been observed in opioid-related overdose rates and consequent emergency department visits, hospital use, and deaths,” Lyna Z. Schieber, MD, DPhil, from the National Center for Injury Prevention and Control at the CDC, and colleagues wrote. “Long-term trend data on opioid prescribing have been published at the county but not the state level.”

“However, the states have jurisdictional responsibility to establish and fund state- and often county-level intervention programs, as well as to change state policies, licensing, regulations, legislation, medical reimbursements, surveillance, and professional education concerning prescriptions written,” they added.

Over a period of 12 years, the number of opioids prescribed per person decreased, whereas the prescribing rate for long-term prescriptions increased.

Source: Adobe Stock

Between 2006 and 2017, Schieber and colleagues analyzed data from outpatient prescribing records from the ICVIA Xponent database to examine the temporal trends and geographic variations in essential measures of opioid prescriptions filled at a retail pharmacy in each state and Washington, D.C.

The essential opioid prescribing measures assessed included:

• annual number of opioids prescribed in morphine milligram equivalents (MME) per person;
• mean duration per prescription in days;
• prescriptions for 3 or fewer days;
• prescriptions for 30 days or longer;
• prescriptions with a high daily dosage (≥ 90 MME); and
• prescriptions for extended-release and long-acting formulations.

The researchers estimated that every year, 233.7 million opioid prescriptions were filled in United States’ retail pharmacies.

All states demonstrated decreases in the mean number of opioids prescribed (mean decrease, 12.8%), high daily dosage (mean decrease, 53.1%), short-term (≤ 3 days) duration (mean decrease, 43.1%) and extended-release and long-acting formulations (mean decrease, 4.7%).

However, all states showed a statistically significant increase in the mean prescription

duration (mean increase, 37.6%). There was also a statistically significant increase in long-term (≥ 30 days) duration of opioid prescriptions in 39 states.

Across states, there were considerable variations in these measures.

“These data provide state programs with their profile for these indicators,” Schieber and colleagues concluded. “State health officials can judge the relative severity of any excess dosage, duration, and/or use of long-term formulations in their jurisdiction. These data may indicate high-potential areas for opioid use prevention and intervention, whether by program interventions, regulations, state-based reimbursement systems, required opioid education for prescribers and pharmacists, enhanced prescription drug monitoring programs (now used in all states), or other means.” – by Alaina Tedesco

Disclosures: The authors report no relevant financial disclosures.