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Opioid painkiller prescribing declines in United States, yet remains too high


Prescriptions for highly addictive opioids fell in the United States between 2012 and 2015, according to new research from the Centers for Disease Control and Prevention.

Although there has been a gradual drop in prescriptions for opioids in the United States since 2010, the number of prescriptions written for painkillers is three times as high as it was in 1999, according to a new government report.

"Second, physicians must continue to lead efforts to reverse the epidemic by using prescription drug monitoring programs, eliminating stigma, prescribing the overdose reversal drug naloxone and enhancing their education about safe opioid prescribing and effective pain management", the AMA concluded.

The report analyzed retail prescription data at the county level from 2006 to 2015. MME is the amount of opioids in milligrams, accounting for differences among various drug types and strengths. Daily MME was also calculated and it showed that between 2006 and 2010 it remained similar and declined by 17% between 2010 and 2015 from 58 MME to 48 MME. But even with the drop, the prescribing rates were three times as high in 2015 as they were in 1999. This shows that the healthcare providers differ in their prescribing practices of opioids in different locations and thus patients receive non-uniform care.

Gary Mendell, founder of the anti-drug advocacy group Shatterproof, noted "the improvements being made", citing estimates that 80 percent of opioid abusers first become addicted to prescription narcotics, not street drugs. All, however, saw significant reductions in prescribing levels from 2010 to 2015.

"In 2011 and 2012, OH and Kentucky, respectively, mandated that clinicians review Prescription Drug Monitoring Program data and implemented pain clinic regulation", the team noted.

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While the CDC a year ago released a guideline for prescribers on the use of opioids - pointing to alternatives or smaller initial doses - states like CT created laws to stymie the flow of prescription opioids. Doctors and pharmacists will now be required to check the database prior to writing an opioid prescription to a patient. Customers of Cigna Health Insurance, for instance, have consumed almost 12 percent fewer opioids in the past year, according to Will Lopez, senior medical director of Cigna Behavioral Health.

Schuchat said CDC's new guidelines have helped and she said the agency is beginning a new push to educate doctors and patients about when opioids are needed and when they are not. These guidelines are applicable for health systems, states, and insurers as well says the CDC.

Separately, some states - Connecticut, Massachusetts, Rhode Island, New York and ME - have adopted legislation that limits opioid prescriptions to seven days.

She added that it's not enough just to try to reduce the number of prescriptions handed out. "But our staff has done intensive analyses to see whether changing policies for prescription drugs shifts people into illicit use, and the answer is no". "We're still seeing too many people get too much for too long".

Similarly, Muskogee, Bryan, Murray and Carter counties were among the 10 counties with the highest amounts of opioids prescribed, and each of those four counties is in the top 10 for high rates of opioid overdose deaths.

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