Opioid Prescribing is Still High and Varies from County to County
Where you live makes a difference
There has been an overall decline in the amount of opioids prescribed in the United States. But the amount is still extremely high, with the amount of prescribed opioids in 2015 approximately three times higher than the amount in 1999. The amount of opioids being prescribed in the United States varies county by county. Half of US counties have seen a decrease in the amount of opioids prescribed from 2010-2015, but the highest prescribing counties still prescribe six times more than the amounts of the lowest prescribing counties.
This Vital Signs examined opioid prescribing data from 2006-2015, including rates, amounts, dosages, and durations they were prescribed, and the report looks at the amounts prescribed by county from 2010-2015. The amount of opioids prescribed is measured by morphine milligram equivalents (MME) or the amount of opioids measured in milligrams, which accounts for the differences in opioid drug type and strength.
The counties that had the highest prescribing rates had some similar qualities, such as: greater percentage of non-Hispanic white residents, greater prevalence of diabetes and arthritis, micropolitan status (small cities and big towns, but non-metro), and higher unemployment.
Healthcare providers can follow the CDC Guideline for Prescribing Opioids for Chronic Pain, which includes recommendations such as:
- Use opioids only when benefits outweigh risks.
- Start with the lowest effective dose of immediate-release opioids. For acute pain, prescribe only the number of days that the pain is expected to be severe enough to require opioids.
- Reassess benefits and risks when considering dose increases. Healthcare providers can also use state-based prescription drug monitoring programs (PDMPs) to help identify patients at risk of addiction or overdose.
CDC Media Relations
“The amount of opioids prescribed in the U.S. is still too high, with too many opioid prescriptions for too many days at too high a dosage. Healthcare providers have an important role in offering safer and more effective pain management while reducing risks of opioid addiction and overdose.”
Anne Schuchat, MD – Principal Deputy Director, Centers for Disease Control and Prevention
“While some variation in opioid prescribing is expected and linked to factors such as the prevalence of painful conditions, differences in these characteristics explain only a fraction of the wide variation in opioid prescribing across the United States. This variation highlights the need for health care providers to consider evidence-based guidance when prescribing opioids.”
Debbie Dowell, MD, MPH – Chief Medical Officer, Division of Unintentional Injury Prevention (DUIP), National Center for Injury Prevention and Control (NCIPC)
- Press Release: Opioids – English | Spanish
- Morbidity and Mortality Weekly Report (MMWR): Vital Signs: Changes in Opioid Prescribing in the United States, 2006-2015
- Vital Signs: Home | July 2017 Vital Signs | Fact Sheet Cdc-pdf[PDF 4.68MB] | Topics
- Vital Signs: (Spanish) Home | 2017 Julio – Signos Vitales | Fact Sheet Cdc-pdf[PDF 4.68MB] | Topics
- CDC Opioid Overdose Website
- CDC Guideline for Prescribing Opioids for Chronic Pain
- Online Training Series for Healthcare Providers
- Prescription Drug Monitoring Program (PDMP)
- CDC Opioid Overdose Website
- CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016
- Healthcare Provider Resources
- Patient Materials
- Resource Center
- CDC Learning Connection: Hot Training Topic
- U.S. Department of Health & Human Services Strategy for Fighting Opioid CrisisExternal
- Substance Abuse and Mental Health Services Administration (SAMHSA)External
- National Institute on Drug AbuseExternal
- U.S. Food and Drug Administration – Drugs InformationExternal
- Drug Enforcement Administration – Office of Diversion ControlExternal
- Centers for Medicare & Medicaid ServicesExternal
- PDMP Center of Excellence, Brandeis UniversityExternal
- JAMA Special Communication: CDC Guideline for Prescribing Opioids for Chronic PainExternal
- New Data on Opioid Use and Prescribing in the United StatesExternal
- Providers’ Clinical Support System for Medication Assisted TreatmentExternal
- Providers’ Clinical Support System for Opioid TherapiesExternal
- MedlinePlus – Prescription Drug AbuseExternal
- MedlinePlus – Pain RelieversExternal
- Opioid Abuse and AddictionExternal
- Abuso y adicción de opioids (Español)External
- Office of the National Coordinator for Health Information Technology (ONC) – Linking PDMPs to Health ITExternal
- National Alliance for Model State Drug LawsExternal
- Vital Signs – Opioid Prescribing: Where you live matters English [Podcast – 1:15 minutes] | Spanish [Podcast 1:15 minutes]
- Vital Signs – Opioid Prescribing: Where you live matters [PSA – 0:60 seconds]