The amount and rate of opioids prescribed, as well as the rate of high-dose prescriptions, have decreased from 2015 to 2017, according to a research letter published in JAMA Internal Medicine.

Despite this trend, opioids were prescribed at a rate of 512.6 morphine milligram equivalent (MME) per capita in 2017, which is nearly triple the amount prescribed in 1999.

The study was based on data from IQVIA’s Xpontent database comprised of prescriptions dispensed from approximately 50,400 retail pharmacies in the United States. The researchers analyzed opioid prescribing rates at the national and county levels for 2015 and 2017. They assessed overall prescribing rates, MME per capita, average daily MME per prescription, and average and median prescription duration.

From 2015 to 2017, the amount of opioids prescribed in the United States decreased by 20.1%, from 641.4 MME to 512.6 MME per capita. The opioid prescribing rates per 100 persons decreased by 16.9%, from 70.7 to 58.7 per 100 persons. High-dose prescribing rates also decreased, dropping from 6.7 to 5.0 per 100 persons, a decrease of 25.3%. The average daily MME per prescription decreased by 6.0%, from 48.1 MME to 45.2 MME.

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The average duration of opioid prescriptions increased by 3.4% between 2015 and 2017, from 17.7 to 18.3 days. The median duration increased by 33.3%, from 15.0 to 20.0 days.

At the county level, the amount of opioids prescribed per capita varied significantly in 2017. In the highest quartile, the average amount of opioids prescribed was 1061.0 MME per capita, a quantity which is 5.8 times that prescribed in the lowest quartile (182.8 MME per capita). Between 2015 and 2017, the majority of counties saw a reduction in the amount of opioids prescribed (74.7%), in overall prescribing rates (76.3%), and in high-dose prescription rates (76.6%).

“Despite reductions in prescribing, opioid overdose rates continue to increase and are driven largely by illicitly manufactured fentanyl,” the researchers note.

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Reference

Guy GP Jr., Zhang K, Schieber LZ, Young R, Dowell D. County-level opioid prescribing in the United States, 2015 and 2017. JAMA Intern Med. 2019;179:574-576.