Karin Ann Mack1, Christopher McCall Jones2, Roderick John McClure1. 1. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. 2. Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Washington, DC, USA.
Abstract
Objective: An average of 91 people in the United States die every day from an opioid-related overdose (including prescription opioids and heroin). The direct dispensing of opioids from health care practitioner offices has been linked to opioid-related harms. The objective of this study is to describe the changing nature of the volume of this type of prescribing at the state level. Methods: This descriptive study examines the distribution of opioids by practitioners using 1999-2015 Automation of Reports and Consolidated Orders System data. Analyses were restricted to opioids distributed to practitioners. Amount distributed (morphine milligram equivalents [MMEs]) and number of practitioners are presented. Results: Patterns of distribution to practitioners and the number of practitioners varied markedly by state and changed dramatically over time. Comparing 1999 with 2015, the MME distributed to dispensing practitioners decreased in 16 states and increased in 35. Most notable was the change in Florida, which saw a peak of 8.94 MMEs per 100,000 persons in 2010 (the highest distribution in all states in all years) and a low of 0.08 in 2013. Discussion: This study presents the first state estimates of office-based dispensing of opioids. Increases in direct dispensing in recent years may indicate a need to monitor this practice and consider whether changes are needed. Using controlled substances data to identify high prescribers and dispensers of opioids, as well as examining overall state trends, is a foundational activity to informing the response to potentially high-risk clinical practices.
Objective: An average of 91 people in the United States die every day from an opioid-related overdose (including prescription opioids and heroin). The direct dispensing of opioids from health care practitioner offices has been linked to opioid-related harms. The objective of this study is to describe the changing nature of the volume of this type of prescribing at the state level. Methods: This descriptive study examines the distribution of opioids by practitioners using 1999-2015 Automation of Reports and Consolidated Orders System data. Analyses were restricted to opioids distributed to practitioners. Amount distributed (morphine milligram equivalents [MMEs]) and number of practitioners are presented. Results: Patterns of distribution to practitioners and the number of practitioners varied markedly by state and changed dramatically over time. Comparing 1999 with 2015, the MME distributed to dispensing practitioners decreased in 16 states and increased in 35. Most notable was the change in Florida, which saw a peak of 8.94 MMEs per 100,000 persons in 2010 (the highest distribution in all states in all years) and a low of 0.08 in 2013. Discussion: This study presents the first state estimates of office-based dispensing of opioids. Increases in direct dispensing in recent years may indicate a need to monitor this practice and consider whether changes are needed. Using controlled substances data to identify high prescribers and dispensers of opioids, as well as examining overall state trends, is a foundational activity to informing the response to potentially high-risk clinical practices.
Authors: Matthew Daubresse; Hsien-Yen Chang; Yuping Yu; Shilpa Viswanathan; Nilay D Shah; Randall S Stafford; Stefan P Kruszewski; G Caleb Alexander Journal: Med Care Date: 2013-10 Impact factor: 2.983
Authors: Chris Delcher; Alexander C Wagenaar; Bruce A Goldberger; Robert L Cook; Mildred M Maldonado-Molina Journal: Drug Alcohol Depend Date: 2015-02-19 Impact factor: 4.492
Authors: F Modarai; K Mack; P Hicks; S Benoit; S Park; C Jones; S Proescholdbell; A Ising; L Paulozzi Journal: Drug Alcohol Depend Date: 2013-02-08 Impact factor: 4.492
Authors: Adam N Romman; Connie M Hsu; Lin-Na Chou; Yong-Fang Kuo; Rene Przkora; Rajnish K Gupta; M James Lozada Journal: Pain Med Date: 2020-11-07 Impact factor: 3.637
Authors: Fedor F Cabrera; Erik R Gamarra; Tiffany E Garcia; Ashanti D Littlejohn; Poul A Chinga; Luis D Pinentel-Morillo; Jorge R Tirado; Daniel Y Chung; Leana J Pande; Kenneth L McCall; Stephanie D Nichols; Brian J Piper Journal: PeerJ Date: 2019-01-15 Impact factor: 2.984