Number of painkiller prescriptions decline statewide, but remain high in many individual counties

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Kentucky Health News reported in July about a Centers for Disease Control and Prevention report showing ranges of painkillers sold per person in each county in 2015 and whether there had been an increase or decrease since 2010. Individual county data was unavailable at the time of the July report, but has since been made available.

The CDC report calculated the rate of “morphine equivalent doses” sold at retail pharmacies in 2010 and 2015 in each county and whether there had been an increase or decrease if the change was greater than or equal to 10 percent Counties with changes of less than 10 percent were labeled “stable.”

Morphine equivalent doses, in milligrams, are determined by a calculation that allows health-care providers to understand how potent one opioid is compared to another.

The report found that painkiller prescriptions had declined statewide, but increased or remained high in many counties from 2010 to 2015.

Opioid doses per person decreased in 71 counties, increased in 19, and were considered stable in 24. Six counties didn’t have enough data to show a trend. The report does not account for people who fill their prescription in one county but live in another.

On the 2015 map, the counties are shaded by quartiles, each representing one-fourth of the total range. Below is a table of the top quartile, showing the 30 Kentucky counties with the most doses per person of opioid painkillers in 2015.

The report gives partial credit for the decline to the Kentucky All Schedule Prescription Electronic Reporting (KASPER) system, which went from voluntary to mandatory during the period.

The report says, “The substantial variation in opioid prescribing observed at the county level suggests inconsistent practice patterns and a lack of consensus about appropriate opioid use, and demonstrates the need for better application of guidance and standards around opioid prescribing practices.”

It says counties with higher amounts of opioids tended to have “a larger percentage of non-Hispanic whites; higher rates of uninsured and Medicaid enrollment, lower educational attainment; higher rates of unemployment; micropolitan status [counties with towns of 10,000 to 50,000]; more dentists and physicians per capita; a higher prevalence of diagnosed diabetes, arthritis, and disability; and higher suicide rates.”

The data for the study came from the Quintiles IMS Transactional Data Warehouse. It does not include prescriptions dispensed directly by prescribers.

From Kentucky Health News

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