Pubdate: Thu, 06 Jul 2017
Source: Philadelphia Daily News (PA)
Copyright: 2017 Philadelphia Newspapers Inc.
Author: Dennis Thompson


Prescriptions for opioid painkillers have dropped since 2010 in the 
United States, but the number of Americans getting the highly addictive 
medications is still too high, a new report shows.

Prescriptions declined from a peak of 782 morphine milligram
equivalents (MME) per person in 2010 to 640 MME per person in 2015,
according to researchers from the U.S. Centers for Disease Control and

"Half of U.S. counties saw a decrease in the amount of opioids
prescribed per person from 2010 to 2015," said CDC Acting Director Dr.
Anne Schuchat. "Overall, opioid prescribing in the United States is
down 18 percent since 2010."

But the total amount of opioids prescribed in 2015 was still about
three times that of 1999, the CDC researchers said, with many people
being provided lengthy prescriptions of the narcotics at high doses.

"We're still seeing too many getting too much for too long," Schuchat
said. "The amount of opioids prescribed in 2015 was enough for every
American to be medicated around the clock for three weeks."

Drug overdoses accounted for just over 52,400 deaths in 2015, and
nearly two of three overdoses involved an opioid, according to the

Prescriptions are still providing high doses of opioid painkillers,
such as OxyContin, for periods long enough to turn patients into
addicts, Schuchat noted.

People are being handed opioid prescriptions that cover longer periods
of time, increasing from an average 13 days in 2006 to almost 18 days
in 2015, the report found.

"Anyone taking opioids can become addicted to them. After taking them
for just a few days, a person becomes more likely to take them long
term," Schuchat said. "Taking even a low-dose opioid for more than
three months increases the risk of addiction by 15 times."

Patients also are being prescribed dangerously high levels of opioids,
even though the average daily dose per prescription decreased from 58
MME in 2010 to 48 MME in 2015. Researchers use MME as a means of
accounting for differences in opioid drug types and strengths.

Schuchat noted that a dose of 50 MME or more doubles a person's risk
of opioid overdose death, compared with 20 MME or less per day. At 90
MME or more, overdose death risk is 10-fold higher.

The availability of prescription opioids varies widely across the
country, Schuchat said.

Residents of the highest-prescribing U.S. counties received six times
more opioids per person than people in the nation's lowest-prescribing
counties in 2015, the researchers said.

"Opioid prescribing varies from place to place as much as the
weather," Schuchat said. "Even neighboring counties can have a major
difference in prescribing levels."

Access to these painkillers varies based on where a person lives and
which doctor they see, the investigators found. More opioids were
prescribed in counties with small cities or towns, a larger percentage
of white residents, higher rates of unemployment and Medicaid
enrollment, and a higher prevalence of diabetes and arthritis.

The Appalachian Mountains remain the region hardest hit by the opioid
epidemic, Schuchat said, but she added that "no part of the country is

"We see within every state some high-prescribing counties," Schuchat
said. "Today, there are very few towns, cities or even families that
don't have some connection with the opioid problem."

The report praised Ohio, Kentucky and Florida as states in which
significant reductions have occurred, thanks to prescription
monitoring and public health programs that target hot spots and
promote alternative means to relieve chronic pain.

"It's fairly impressive how much improvement there was throughout the
state of Florida," Schuchat said. There, the amount of opioids
prescribed per person decreased in four out of five counties between
2010 and 2015, and overdose deaths also dropped.

The report was published online July 6 in the Journal of the American
Medical Association.
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