U.S. Opioid Dispensing Rate Maps

The data in the maps show the geographic distribution in the United States, at both state and county levels, of retail opioid prescriptions dispensed per 100 persons per year from 2006–2020. ^1,2,3,4

Data are displayed within two types of interactive maps that show the estimated rate of opioid prescriptions per 100 U.S. residents. The state maps portray the rates per year for each of the 50 states and the District of Columbia. The county maps portray these rates for 87.1% to 98.5% of U.S. counties for a given year from 2006-2020.⁵

Rates are classified by the Jenks⁶ natural breaks classification method into four groups using the 15-year range of data to determine the class breaks. Click on a county or state to reveal its opioid dispensing rate or view the corresponding data table for additional information.

Key Highlights

• After a steady increase in the overall national opioid dispensing rate starting in 2006, the total number of prescriptions dispensed peaked in 2012 at more than 255 million and a dispensing rate of 81.3 prescriptions per 100 persons.
• The overall national opioid dispensing rate declined from 2012 to 2020, and in 2020, the dispensing rate had fallen to the lowest in the 15 years, for which we have data at 43.3 prescriptions per 100 persons (total of more than 142 million opioid prescriptions).
• However, in 2020, dispensing rates continued to remain very high in certain areas across the country.
  • In 3.6% of U.S. counties, enough opioid prescriptions were dispensed for every person to have one.
  • While the overall opioid dispensing rate in 2020 was 43.3 prescriptions per 100 people, some counties had rates that were nine times higher than that.
• Dispensing rates for opioids vary widely across different states and counties. Emerging hotspot areas are identified by the darker colors on the maps.

Table 1. Total number and rate of opioid prescriptions dispensed, United States, 2006–2020

Table 2. Total number and percentage of counties with available opioid dispensing data, United States, 2006–2020 ⁵

Sources and Footnotes

1. Source for all dispensing data: IQVIA Xponent 2006–2020. IQVIA Xponent is based on a sample of approximately 50,400 retail (non-hospital) pharmacies, which dispense nearly 92% of all retail prescriptions in the United States. For this database, a prescription is a new or refill prescription dispensed at a retail pharmacy in the sample and paid for by commercial insurance, Medicaid, Medicare, cash or its equivalent, and other third-party coverage. This database does not include mail order prescriptions.
2. For the calculation of dispensing rates, numerators are the projected total number of opioid prescriptions dispensed annually at the state, county, or national level. Annual resident population denominators were obtained from the U.S. Census Bureau.
3. Opioid prescriptions, including buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol, and tramadol, were identified using National Drug Codes. All prescriptions with days’ supply between 1 and 365 days and a known strength description were included. Cough and cold formulations containing opioids and buprenorphine products typically used to treat opioid use disorder were not included. In addition, methadone dispensed through methadone treatment programs is not included in the IQVIA Xponent data.
4. In January 2019, IQVIA changed the frame of measurement in their projected prescription services from reflecting prescription demand to be “number of prescriptions dispensed to bin” to reflecting total prescriptions actually “sold to the patient.”  To do this, IQVIA eliminated the effects of voided and reversed prescriptions (prescriptions that were never received by the patient) beginning in 2017. This change in measurement frame resulted in a 1.9% downward shift in the measured opioid prescriptions dispensed. This enhancement was applied to data from 2017 and thereafter. Thus, caution should be exercised when examining trends during this time period.
5. Table 2 displays the percentage of counties in the United States that have opioid dispensing rates available for a given year. A lack of available data may indicate that the county had no retail pharmacies and/or prescribers, the county had no retail pharmacies and/or prescribers sampled, or the prescription volume was erroneously attributed to an adjacent, more populous county according to the sampling rules used.
6. Jenks, George F. 1967. “The Data Model Concept in Statistical Mapping,” International Yearbook of Cartography 7: 186–190.
7. Starting in 2019, prescriptions were based on the location of the prescriber, rather than the location of the pharmacy.