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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.

Anne Schuchat, MD


Anne Schuchat, M.D.

“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

Debbie Dowell, MD, MPH


Debbie Dowell, MD, MPH

“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)

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