Brian J Piper1, Dipam T Shah2, Olapeju M Simoyan3, Kenneth L McCall4, Stephanie D Nichols5. 1. Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. Electronic address: bpiper@som.geisinger.edu. 2. Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. 3. Department of Clinical Sciences, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. 4. Department of Pharmacy Practice, University of New England, Portland, Maine. 5. Department of Pharmacy Practice, Husson University School of Pharmacy, Bangor, Maine; Department of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts.
Abstract
INTRODUCTION: The U.S. is experiencing an opioid epidemic which is at least partially iatrogenic and fueled by both prescription and illicit misuse. This study provides a nationwide examination of opioid distribution patterns during the last decade. METHODS: Data were obtained from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System for 2006-2016. Analyses include quantities of ten opioids legally dispensed nationwide by weight and converted to Morphine Milligram Equivalents. Geospatial and state-level analyses were also completed in 2017. RESULTS: The total for ten opioids peaked in 2011 (389.5 metric tons Morphine Milligram Equivalents) relative to both 2006 (286.1) and 2016 (364.6). Changes in the volume of opioids by weight over the decade were agent specific. Since 2011, there were decreases in hydrocodone (-28.4%); oxymorphone (-28.0%); fentanyl (-21.4%); morphine (-18.9%); oxycodone (-13.8%); and meperidine (-58.0%) and an increase in buprenorphine (75.2%) in 2016. There were substantial inter-state variations in rates with a fivefold difference between the highest Morphine Milligram Equivalents in 2016 (Rhode Island=2,623.7 mg/person) relative to the lowest (North Dakota=484.7 mg/person). An association was identified between state median age and per capita Morphine Milligram Equivalents (r =0.49, p<0.0005). CONCLUSIONS: With the exception of buprenorphine, used to treat an opioid use disorder, prescription opioid use has been decreasing over the past 5 years in the U.S. Further efforts are needed to continue to optimize the balance between appropriate opioid access for acute pain while minimizing diversion and treating opioid addiction.
INTRODUCTION: The U.S. is experiencing an opioid epidemic which is at least partially iatrogenic and fueled by both prescription and illicit misuse. This study provides a nationwide examination of opioid distribution patterns during the last decade. METHODS: Data were obtained from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System for 2006-2016. Analyses include quantities of ten opioids legally dispensed nationwide by weight and converted to Morphine Milligram Equivalents. Geospatial and state-level analyses were also completed in 2017. RESULTS: The total for ten opioids peaked in 2011 (389.5 metric tons Morphine Milligram Equivalents) relative to both 2006 (286.1) and 2016 (364.6). Changes in the volume of opioids by weight over the decade were agent specific. Since 2011, there were decreases in hydrocodone (-28.4%); oxymorphone (-28.0%); fentanyl (-21.4%); morphine (-18.9%); oxycodone (-13.8%); and meperidine (-58.0%) and an increase in buprenorphine (75.2%) in 2016. There were substantial inter-state variations in rates with a fivefold difference between the highest Morphine Milligram Equivalents in 2016 (Rhode Island=2,623.7 mg/person) relative to the lowest (North Dakota=484.7 mg/person). An association was identified between state median age and per capita Morphine Milligram Equivalents (r =0.49, p<0.0005). CONCLUSIONS: With the exception of buprenorphine, used to treat an opioid use disorder, prescription opioid use has been decreasing over the past 5 years in the U.S. Further efforts are needed to continue to optimize the balance between appropriate opioid access for acute pain while minimizing diversion and treating opioid addiction.
Authors: Patricia Eckardt; Donald Bailey; Holli A DeVon; Cynthia Dougherty; Pamela Ginex; Cheryl A Krause-Parello; Rita H Pickler; Therese S Richmond; Eleanor Rivera; Carol F Roye; Nancy Redeker Journal: Nurs Outlook Date: 2020-04-09 Impact factor: 3.250
Authors: Andrew I Geller; Deborah Dowell; Maribeth C Lovegrove; Jana K McAninch; Sandra K Goring; Kathleen O Rose; Nina J Weidle; Daniel S Budnitz Journal: Am J Prev Med Date: 2019-03-06 Impact factor: 5.043
Authors: Tae Woo Park; Marc R Larochelle; Richard Saitz; Na Wang; Dana Bernson; Alexander Y Walley Journal: Addiction Date: 2020-01-20 Impact factor: 6.526
Authors: Xuerong Wen; Nicholas Belviso; Rebecca Lebeau; Jeff Bratberg; Brandi Cotton; Kristina Ward; Debra Erickson-Owens; Stephen Kogut Journal: R I Med J (2013) Date: 2019-08-01
Authors: April D Summers; Elizabeth C Ailes; Michele K Bohm; Emmy L Tran; Cheryl S Broussard; Meghan T Frey; Suzanne M Gilboa; Jean Y Ko; Jennifer N Lind; Margaret A Honein Journal: J Opioid Manag Date: 2021 Mar-Apr