MMWR News Synopsis for January 18, 2019

Opioid Prescribing Rates in Nonmetropolitan and Metropolitan Counties Among Primary Care Providers Using an Electronic Health Record System — United States, 2014–2017

CDC Media Relations
404-639-3286

Although there has been progress in reducing opioid prescribing in both metropolitan and non-metropolitan (rural) areas, opioid prescribing remains significantly higher among primary care providers in rural counties than in metropolitan counties. This finding indicates a need for health care practices and intervention programs tailored to rural communities. Drug overdose is the leading cause of unintentional injury death in the United States, and higher rates of opioid-related deaths have been recorded in rural areas. In 2017, 14 rural counties were among the 15 counties with the highest opioid prescribing rates. This report analyzed opioid prescribing rates among a subset of primary care providers in the United States from January 2014 to March 2017 and found that patients in the most rural counties had an 87 percent greater chance of receiving an opioid prescription than patients in large metropolitan areas. Although opioid prescribing decreased significantly after the March 2016 release of CDC’s Guideline for Prescribing Opioids for Chronic Pain, these findings show that there is still a need for health care practices, intervention programs, and resources tailored to rural communities.

Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates — United States, 2006–2015

CDC Media Relations
404-639-3286

The number of babies born with gastroschisis has increased over time in the United States. In this report, counties with high opioid prescription rates had more than 1.5 times as many babies born with gastroschisis when compared to counties with low opioid prescription rates. These findings signal the need to examine this potential link in future studies. Having a better understanding of all possible effects of opioid use during pregnancy can help inform optimal care for pregnant women and their babies. The number of babies born with a serious birth defect of the abdominal wall, gastroschisis, has increased over time in the United States. Researchers estimated that from 2006-2015, about 1 in every 2,300 babies was born with gastroschisis in selected U.S. states. Previous studies found that young maternal age is a strong risk factor for gastroschisis, but other factors, such as prescription opioid use, might also be associated. This study looked at the occurrence of gastroschisis in 20 states from 2006 to 2015 and saw an increase in most maternal age groups. Researchers linked opioid prescription data with gastroschisis data and found a higher prevalence of gastroschisis where opioid prescriptions rates were high. These findings do not mean that maternal opioid use during pregnancy causes babies to be born with gastroschisis. But it does signal a need for more public health research on opioid use during pregnancy and its overall impact on infant health.

Overdose Deaths Involving Fentanyl and Fentanyl Analogs — New York City, 2000–2017

Stephanie Buhle | Acting Press Secretary
NYC Department of Health and Mental Hygiene
Press office: (347) 396-4177
sbuhle@health.nyc.gov

In light of the opioid overdose crisis, universal toxicology testing for fentanyl by medical examiners and coroners and inclusion of drug-specific language on death certificates are critical to informing surveillance and guiding overdose prevention efforts. From 1999 to 2017, the rate of drug overdose deaths nationally more than tripled. More than 70,000 overdose deaths occurred nationally in 2017, with nearly 68 percent involving an opioid. Using toxicology data, New York City identified fentanyl in 2 percent of drug overdose deaths from 2000 to 2012. By 2017, fentanyl was involved in 57 percent of all drug overdose deaths in New York City. Universal fentanyl testing by local medical examiners and inclusion of drug-specific language on death certificates can aid surveillance and quantify the role of fentanyl in drug overdose deaths. In addition, community-level educational outreach is indicated when an increase in fentanyl involvement is detected.

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Page last reviewed: January 18, 2019