Healthcare providers wrote 259 million prescriptions for opioid painkillers in 2012-many more in some states than in others-according to a Vital Signs report released by the Centers for Disease Control and Prevention (CDC) that highlights the danger of overdose.
Healthcare providers in the highest prescribing state, Alabama, wrote almost three times as many of these prescriptions per person as those in the lowest prescribing state, Hawaii. Most of the highest prescribing states were in the South. Previous research has shown that regional variation in use of prescriptions cannot be explained by the underlying health status of the population.
The Vital Signs report also contains a study that highlights the success of Florida in reversing prescription drug overdose trends. Results showed that after statewide legislative and enforcement actions in 2010 and 2011, the death rate from prescription drug overdose decreased 23 percent between 2010 and 2012. Florida officials had taken these actions in response to a 28 percent increase in the drug overdose death rate over the preceding years (2006-2010).
Declines in death rates in Florida for specific prescription painkillers (oxycodone, methadone, and hydrocodone) and sedatives paralleled declines in prescribing rates for those drugs.
“Prescription drug overdose is epidemic in the United States. All too often, and in far too many communities, the treatment is becoming the problem,” said CDC Director Tom Frieden, MD, MPH. “Overdose rates are higher where these drugs are prescribed more frequently. States and practices where prescribing rates are highest need to take a particularly hard look at ways to reduce the inappropriate prescription of these dangerous drugs.”
Key findings of the report include the following:
- Southern states-Alabama, Tennessee, and West Virginia in particular-had the most painkiller prescriptions per person.
- The Northeast, especially Maine and New Hampshire, had the most prescriptions per person for long-acting/extended-release painkillers and for high-dose painkillers.
- State variation was the greatest for oxymorphone (a specific type of painkiller), among all prescription painkillers. Nearly 22 times as many prescriptions were written for oxymorphone in Tennessee as were written in Minnesota.
“We know we can do better. State variation in prescribing shows us that the overprescribing of opioids can be reduced safely and feasibly,” said Daniel M. Sosin, MD, MPH, FACP, acting director of the CDC’s National Center for Injury Prevention and Control. “Improving how opioids are prescribed will help us prevent the 46 prescription painkiller overdose deaths that occur each day in the United States.”
Previous research has shown that state variation does not necessarily translate to better health outcomes or patient satisfaction. In fact, high rates of use might produce worse outcomes.
While there are several things that states can do to address the overprescribing of painkillers, it is important that patients also play a role. Following are several suggestions:
- Be sure that all of your healthcare providers know what medications the others have prescribed for you.
- Don’t “doctor shop” to try to get more medication than you should legally and safely receive.
- Don’t buy prescription medicine from unauthorized dealers.
- If you suspect that you have been prescribed too much medication or the wrong medication, talk to your doctor or get a second opinion from another doctor.
- Consider getting all of your medication through a single pharmacy. In some cases, the pharmacist might notice that you have been prescribed different medications that should not be taken during the same period.
- Consider alternative therapies-exercise, physical therapy, biofeedback, acupuncture, massage, etc.-to help reduce your need for opiods.
- Carefully read the directions and warnings that come with your medicine. If you have any concerns, discuss them with your doctor.
- If you feel that your medicine is affecting you in a way that it is not supposed to, tell your doctor.
- Store your medication securely so that others can’t steal it or accidentally ingest it.
- Dispose of leftover or expired medicine properly.
- If you feel that you have become addicted to any of your medicine, seek professional assistance.
This article was adapted from information provided by the CDC.
This article is for general informational purposes only and does not constitute medical advice. Always seek the advice of a qualified healthcare professional for your specific situation.
