Quantity of prescribing opioids declined, however the minimize was not uniform throughout geographic areas

The amount of prescription opioids allotted from retail pharmacies declined by 21% from 2008 to 2018, however the decline was not uniform throughout geographic areas, amongst sorts of sufferers or by kind of prescriber, in accordance with a brand new RAND Company examine.

The examine, printed by the Annals of Inner Drugs, is the primary to look at the decline in opioid prescriptions stuffed at retail pharmacies based mostly on each quantity and efficiency of the medicine allotted.

The findings don’t present concrete solutions about how a lot of the pointless prescribing of opioids has been eradicated. However the work demonstrates that there’s a lot extra nuance within the adjustments in opioid prescribing than we beforehand understood.

Dr Bradley D Stein, Research Lead Writer and Senior Doctor Researcher, RAND Company

There may be extensive settlement that the overprescribing of opioid remedy for ache was a key driver in creation of the U.S. opioid disaster, which has led to widespread dependancy and now kills greater than 100,000 Individuals yearly.

State, federal and personal initiatives have been undertaken to encourage physicians and different well being suppliers to cut back the variety of prescriptions written for opioids to deal with ache. The variety of opioid prescriptions peaked in 2011.

RAND researchers examined variations in opioid prescriptions stuffed at pharmacies through the durations of 2008 by 2009 and 2017 by 2018. The prescription data got here from IQVIA Prescription information, which captures about 90% of prescriptions stuffed at U.S. retail pharmacies.

They used days’ provide and complete each day opioid dose to calculate per capita morphine milligram equivalents (MME) for opioid prescriptions stuffed through the examine interval. As a result of opioids can be found in several kinds, this measurement supplies a greater evaluation of the whole quantity of opioids stuffed by sufferers as in comparison with simply the variety of capsules allotted.

The examine discovered that over the examine interval, per capita MME quantity declined probably the most in metropolitan counties (greater than 22%) and in counties with increased charges of deadly opioid overdoses (a 35% decline).

Substantial variation existed each inside and throughout states. In some states, MME quantity per capita elevated in a number of counties. In lots of different states, there have been counties with each will increase and others with substantial decreases. Counties that skilled substantial decreases in per capita MME usually had been adjoining to counties with per capita will increase.

Most medical specialties recorded declines within the MME quantity per training clinician. The best lower in MME quantity per training clinician was amongst grownup major care physicians (40% decline) and ache specialists (15% decline) — the clinicians with the best MME quantity per clinician in 2008-2009.

The best proportion lower was amongst emergency physicians (71% decline) — clinicians who’re doubtless prescribing opioids predominantly to sufferers experiencing acute ache in acute care settings.

“These outcomes recommend the consequences of clinician and policymaker efforts to cut back opioid

prescribing have affected populations in another way,” Stein stated. “Future efforts to reinforce clinically applicable opioid prescribing could must be extra clinically nuanced and focused for particular populations.”


Journal reference:

Stein, B. D., et al. (2021) Change in Per Capita Opioid Prescriptions Crammed at Retail Pharmacies, 2008–2009 to 2017–2018. Annals of Inner Drugs. doi.org/10.7326/M21-3042.

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