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CDC Report: Opioid Painkiller Prescribing Varies Widely Among States

Where people live makes a difference

Health care providers wrote 259 million prescriptions for opioid painkillers in 2012 — many more in some states than in others — according to a new report from the Centers for Disease Control and Prevention (CDC).

Health care providers in the highest prescribing state, Alabama, wrote almost three times as many of these prescriptions per person as did those in the lowest prescribing state, Hawaii. Most of the highest prescribing states were in the South. Previous research has shown that regional variation in the use of prescriptions cannot be explained by the underlying health status of the population, the report says.

The report also contains a study highlighting the success of Florida in reversing prescription drug-overdose trends. Results showed that after statewide legislative and enforcement actions in 2010 and 2011, the death rate from prescription drug overdose decreased 23% between 2010 and 2012. Florida officials had taken these actions in response to a 28% increase in the drug-overdose death rate over the preceding years (2006–2010).

Declines in death rates in Florida for specific prescription painkillers (oxycodone, methadone, and hydrocodone) and sedatives paralleled declines in prescribing rates for those drugs.

The report’s key findings include:

  • Southern states — Alabama, Tennessee, and West Virginia, in particular — had the most painkiller prescriptions per person.
  • The Northeast, especially Maine and New Hampshire, had the most prescriptions per person for long-acting/extended-release painkillers and for high-dose painkillers.
  • State variation was greatest for oxymorphone among all prescription painkillers. Nearly 22 times as many prescriptions were written for oxymorphone in Tennessee as were written in Minnesota.

“Prescription drug overdose is epidemic in the United States. All too often, and in far too many communities, the treatment is becoming the problem,” said CDC Director Tom Frieden, MD, MPH. “Overdose rates are higher where these drugs are prescribed more frequently. States and practices where prescribing rates are highest need to take a particularly hard look at ways to reduce the inappropriate prescription of these dangerous drugs.”

Sources: CDC; July 1, 2014; and MMWR; July 1, 2014.

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