Opi­oid pre­scrib­ing varies widely among U.S. coun­ties, re­port finds

Modern Healthcare - - NEWS - By Steven Ross John­son

In­con­sis­ten­cies in pre­scrib­ing prac­tices are lead­ing to sig­nif­i­cant vari­a­tion across the coun­try in opi­oid us­age, ac­cord­ing to a new gov­ern­ment re­port.

Over­all, an­nual opi­oid pre­scrib­ing rates fell 13% be­tween 2012 and 2015 to 70.6 pre­scrip­tions for ev­ery 100 peo­ple, ac­cord­ing to a Cen­ters for Dis­ease Con­trol and Pre­ven­tion anal­y­sis.

But the de­cline was not seen across the board, with only half of U.S. coun­ties ex­pe­ri­enc­ing re­duc­tions in that pe­riod. The amount of opi­oids per res­i­dent in the high­est-pre­scrib­ing coun­ties was six times more than the amount found in the low­est-pre­scrib­ing coun­ties, the CDC found.

Higher-pre­scrib­ing coun­ties shared a num­ber of char­ac­ter­is­tics: higher rates of unin­sured and Med­i­caid en­roll­ment; higher rates of un­em­ploy­ment; a high preva­lence of such chronic con­di­tions as arthri­tis and di­a­betes, or peo­ple suf­fer­ing from a dis­abil­ity; higher sui­cide rates; a larger per­cent­age of non-His­panic whites. Th­ese coun­ties also had larger con­cen­tra­tions of den­tists and pri­mary-care physi­cians, the med­i­cal spe­cial­ties that do most of the pre­scrib­ing of opi­oids.

The CDC’s Dr. Anne Schuchat said such fac­tors ex­plained only about onethird of the vari­a­tions in opi­oid pre­scrib­ing. It was not en­tirely clear what was driv­ing the other two-thirds. “Clin­i­cal prac­tice is re­ally all over the

The re­port’s find­ings of­fer a base­line mea­sure of the scope of the opi­oid epi­demic prior to the CDC’s re­lease of its opi­oids pre­scrib­ing guide­lines for chronic pain in March 2016.

place, which is usu­ally a sign that you need bet­ter stan­dards,” Schuchat said dur­ing a call with re­porters.

Schuchat said the re­port’s find­ings of­fer a base­line mea­sure of the scope of the opi­oid epi­demic prior to the CDC’s re­lease of its opi­oids pre­scrib­ing guide­lines for chronic pain in March 2016, and that plans were un­der­way to ex­am­ine in the next year or so how the num­bers may have changed since the rec­om­men­da­tions were is­sued.

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