Science & Technology

Opioid prescriptions decrease, but reductions are not uniform – the crisis kills more than 100,000 Americans annually

We found different differences by region, age group, and type of prescriber.

According to a new RAND Corporation survey, the amount of prescription opioids dispensed from retail pharmacies decreased by 21% between 2008 and 2018, but decreased across geographic areas, between patient types, or by prescribing type. Was not uniform.

Published by the Annual Report of Internal Medicine, this study is the first to examine a reduction in opioid prescriptions filled in retail pharmacies based on both the amount and efficacy of dispensed drugs.

“The results of this study do not provide a concrete answer as to how much unnecessary prescriptions for opioids have been eliminated,” said the lead author of the study and the doctor’s study of RAND, a nonprofit research organization. Dr. Bradley D. Stein said. “But this study shows that changing opioid prescriptions has far more nuances than previously understood.”

Regarding the fact that over-prescribing opioid drugs for pain is a major driver of the outbreak of the opioid crisis in the United States, which has caused widespread addiction and currently kills more than 100,000 Americans each year. Widely agreed.

State, federal, and private initiatives have been implemented to encourage physicians and other healthcare providers to reduce the number of prescriptions written for opioids to treat pain. The number of opioid prescriptions peaked in 2011.

RAND researchers investigated the differences in opioid prescriptions prescribed in pharmacies between 2008-2009 and 2017-2018. Prescription information was obtained from IQVIA prescription data, which captures approximately 90% of prescriptions prescribed at retail pharmacies in the United States.

They used a daily supply and a total daily opioid dose to calculate the per capita morphine milligram equivalent (MME) of opioid formulations filled during the study period. Because opioids are available in a variety of forms, this measurement provides a better assessment of the total amount of opioids the patient has filled, compared to just the number of tablets dispensed.

According to the survey, per capita MME levels were highest during the study period in metropolitan counties (> 22%) and in counties with high rates of fatal opioid overdose (35% reduction).

There was considerable variation within and between states. In some states, per capita MME levels increased in multiple counties. In many other states, some counties were both increasing and some were significantly decreasing. The counties with a significant decrease in MME per capita were often adjacent to the counties with an increase in per capita.

Most clinical specialists have recorded a decrease in the amount of MME per clinician. The largest reduction in MME per clinician was between adult primary care physicians (40% reduction) and pain specialists (15% reduction). The clinician with the highest amount of MME per clinician from 2008 to 2009.

The largest reduction was among emergency physicians (71% reduction) — clinicians likely to be prescribing opioids to patients experiencing acute pain, primarily in an acute care environment.

“These results suggest the benefits of clinician and policymaker efforts to reduce opioids.

Prescriptions have had different effects on the population, “Stein said. “Future efforts to enhance clinically appropriate opioid prescriptions may have more clinically subtle differences and may need to be targeted to a specific population.”

Reference: “Changes in per capita opioid prescriptions filled out at retail pharmacies, 2008-2009-2017-2018” December 27, 2021 Annual report of internal medicine..

Other authors of this study are Erin A. Taylor, Florashen, Andrew W. Dick, Mary Viana, and Mark Solbello.

RAND Health Care promotes a healthier society by improving the healthcare system in the United States and other countries.

Opioid prescriptions decrease, but reductions are not uniform – the crisis kills more than 100,000 Americans annually Opioid prescriptions decrease, but reductions are not uniform – the crisis kills more than 100,000 Americans annually

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