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. 2014 Jul 4;63(26):563-8.

Vital signs: variation among States in prescribing of opioid pain relievers and benzodiazepines - United States, 2012

Leonard J Paulozzi, Karin A Mack, Jason M Hockenberry; Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC

Vital signs: variation among States in prescribing of opioid pain relievers and benzodiazepines - United States, 2012

Leonard J Paulozzi et al. MMWR Morb Mortal Wkly Rep. .

Abstract

Background: Overprescribing of opioid pain relievers (OPR) can result in multiple adverse health outcomes, including fatal overdoses. Interstate variation in rates of prescribing OPR and other prescription drugs prone to abuse, such as benzodiazepines, might indicate areas where prescribing patterns need further evaluation.

Methods: CDC analyzed a commercial database (IMS Health) to assess the potential for improved prescribing of OPR and other drugs. CDC calculated state rates and measures of variation for OPR, long-acting/extended-release (LA/ER) OPR, high-dose OPR, and benzodiazepines.

Results: In 2012, prescribers wrote 82.5 OPR and 37.6 benzodiazepine prescriptions per 100 persons in the United States. State rates varied 2.7-fold for OPR and 3.7-fold for benzodiazepines. For both OPR and benzodiazepines, rates were higher in the South census region, and three Southern states were two or more standard deviations above the mean. Rates for LA/ER and high-dose OPR were highest in the Northeast. Rates varied 22-fold for one type of OPR, oxymorphone.

Conclusions: Factors accounting for the regional variation are unknown. Such wide variations are unlikely to be attributable to underlying differences in the health status of the population. High rates indicate the need to identify prescribing practices that might not appropriately balance pain relief and patient safety.

Implications for public health: State policy makers might reduce the harms associated with abuse of prescription drugs by implementing changes that will make the prescribing of these drugs more cautious and more consistent with clinical recommendations.

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Figures

FIGURE 1
FIGURE 1
Distribution of state prescribing rates,* by drug type — IMS Health, United States, 2012 * State rates are rounded to the nearest 0.25 standard deviation for purposes of presentation.
FIGURE 2
FIGURE 2
Prescribing rates per 100 persons (in quartiles), by state and drug type — IMS Health, United States, 2012
See this image and copyright information in PMC

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