Where Americans are using the most prescription painkillers

Julia Belluz

Opiate medications — such as codeine, morphine and OxyContin — are controversial because, while often prescribed to treat pain, they are extremely addictive and too frequently overused.

Nearly seven million insured Americans filled at least one prescription for an opioid between 2009 to 2013, according to a new report from the pharmacy benefits management company Express Scripts. Their data shows that, while fewer patients are taking opioids these days, those that do are using more opioids for longer periods. This is worrying for two reasons: we know there is an epidemic of overuse in this country, and opioids can be deadly.

"While America claims less than 5 percent of the world's population," the report reads, "it consumes roughly 80 percent of the world's opioid supply." Overdose of these medicines kills more people every year than cocaine and heroine combined, and yet opioids remain the most commonly prescribed painkillers.

Worrying trends

The number of Americans filling prescription opioids dropped by 9 percent between 2009 and 2013, the Express Scripts report shows. But both the number of prescriptions filled and the number of days of medication per prescription rose by over 8 percent. So fewer patients were taking more drugs for longer periods.

Nearly half of the patients in the study who took an opiate for 30 days in the first year of their prescription continued to use the drugs for three years or longer. "Almost 50 percent of those patients were taking only short-acting opioids, putting them at higher risk of addiction," the report reads.

Women filled about 30 percent more prescriptions than men, and prevalence of use increased with age, with those over 65 taking the most opiate painkillers.

Nearly 30 percent of patients on opioids were using other prescription drugs, too — some of which had potentially harmful or even deadly interactions, like benzodiazepines.

Southern states use the most opioids

The most ardent users of opioid drugs were concentrated in four states: Kentucky, Alabama, Georgia, and Arkansas. Forty-one of the 50 cities with the highest prevalence for opioid use in America were found in these four states.

opioid

States with the highest average prevalence of opioid use. (Map via Scripts.)

Of the geographic pattern, the report authors postulate that the prevalence of chronic diseases in the south may be to blame: "There are especially high rates of obesity and diabetes in these states, conditions that often have associated pain that may require opioid treatment."

H/t New York Times

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