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The states with the most opioid painkiller users

July 7, 2014

    Paige Baschuck, Daily Briefing

    Nearly 50 U.S. residents die each day from an overdose of prescription painkillers, according to new CDC data. A shocking fact, but less so when you consider that health providers in 2012 wrote enough prescriptions to give every American adult access to a bottle of painkillers—about 259 million.

    Unsurprisingly, those two statistics are not unrelated. The CDC report shows that states where doctors wrote the most opioid prescriptions in 2012 were also the states with the most painkiller overdose deaths.

    Painkiller nation: How did we get here?

    Health experts say conditions that cause enough pain to warrant such opioid painkiller prescriptions do not vary much from state to state—at least not enough to explain why providers in some states wrote three times as many opioid prescriptions as providers in other states.

    According to CDC, providers in these 13 states wrote the most painkiller prescriptions per patient in 2012: 

    • Alabama;
    • Arkansas;
    • Indiana;
    • Kentucky;
    • Louisiana;
    • Michigan;
    • Mississippi;
    • North Carolina;
    • Ohio;
    • Oklahoma;
    • South Carolina;
    • Tennessee; and
    • West Virginia.

    Meanwhile, providers in these 13 states wrote the fewest painkiller prescriptions per patients:

    • Alaska;
    • California;
    • Colorado;
    • Connecticut;
    • Hawaii;
    • Illinois;
    • Massachusetts;
    • Minnesota;
    • New Jersey;
    • New York;
    • South Dakota;
    • Vermont; and
    • Wyoming.

    Generally, the states with the most opioid prescriptions are concentrated in the South. According to CDC, Tennessee providers in 2012 wrote nearly 22 times more prescriptions for oxymorphone than providers in Minnesota.

    However, providers in Maine and New Hampshire wrote the most prescriptions per patient for long-acting and high-dose painkillers.

    Health experts say some of the variety may occur because health providers in different regions do not agree on when to prescribed painkillers and how much to prescribe.

    But other experts say the increased demand comes from a less savory source: People seeking prescriptions illegally for recreational use or to sell them. Many states have reported dealing with such problems at high-volume pain clinics (sometimes called "pill mills").

    Here at the Daily Briefing, we have certainly covered our fair share of such news:

    What is the nation doing to reverse this trend?

    Providers and policymakers are not sitting idle on this issue.

    Last week, we wrote about how Massachusetts General Hospital will spend millions on screening—and treating when necessary—every ED and inpatient patient for substance abuse beginning in 2015.

    Meanwhile, FDA is trying to prevent opioid abuse by requiring stricter warning labels for long-acting painkiller prescriptions and investing in the development of abuse-proof painkiller. (However, the agency has not mandated painkiller training for doctors.)

    Some states use databases to track prescriptions for painkillers and identify over-prescription problems. Even retail stores, such as CVS, have joined the crackdown by blocking providers' dispensing privileges who have extreme prescription patterns.

    But it's not yet enough. CDC experts say more needs to be done on every level.

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