Opioid prescriptions dropped but remain high, CDC says

Posted July 08, 2017

The number of prescriptions for opioid painkillers is down in most areas of the country, but there are still too many people taking the addictive drugs for too long, according to the Centers for Disease Control and Prevention.

"We still have too many people getting medicine at too high a level and for too long", said Dr. Anne Schuchat, acting director of the CDC. But Schuchat cautioned that as fewer people are receiving short-term prescriptions, those who take opioids for years for chronic pain may have skewed the average.

The amount of opioids prescribed peaked in 2010 at 782 morphine milligram equivalents (MME) per person and decreased to 640 MME in 2015.

Prescriptions are measured by morphine milligram equivalents, which uses morphine as a baseline to measure the equivalent prescribed opioid, which may be more powerful.

The overall prescribing rate fell 13 percent between 2010 and 2015.

Meanwhile, the average supply per prescription increased 33% from 13 days in 2006 to nearly 18 days in 2015.

Mike Massuli, deputy director for addiction services in Cecil County in the northeastern corner of Maryland, said the higher amount prescribed in less populated areas may be because patients have a harder time accessing medical care so doctors could be sending them home with larger quantities.

Recommendations include using opioids only when benefits outweigh the risks, starting with the lowest effective dose of immediate-release opioids, and reassessing the benefits and risks when considering dose increases.

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The opioid crisis has affected people nationwide, with prescription opioids alone killing over 180,000 people from 2000 to 2015.

"In 2011 and 2012, OH and Kentucky, respectively, mandated that clinicians review Prescription Drug Monitoring Program data and implemented pain clinic regulation", the team noted.

CDC officials urge states and counties to use the findings in this report to educate physicians on the appropriate use of opioid painkillers and to help people get better access to treatments for opioid addiction.

MedChi's own data shows that in the four years ending in 2016, opioid prescriptions dropped more than 13 percent in Maryland to fewer than 3.7 million and doctors in the state write fewer prescriptions than the national average.

Louisiana has the sixth-highest opioid pain reliever prescribing rate in the country. Customers of Cigna Health Insurance, for instance, have consumed almost 12 percent fewer opioids in the past year, according to Will Lopez, senior medical director of Cigna Behavioral Health.

But the sheer volume of opioids prescribed that year was still three times higher than in 1999, according to new government data. Schuchat believes these sets of guidelines triggered some improvement, which is reflected in the new report. This year, New Jersey became the strictest, limiting painkiller prescriptions to just five days.

And prescription numbers have actually dropped over the last decade. "We also have far more research supporting the effectiveness of safer medications and even nondrug measures". The death rates from heroin and fentanyl have increased a lot faster than death rates from prescription narcotics.