Trends in Medical Use of Opioids in the U.S., 2006–2016

Piper, Brian J.; Shah, Dipam T.; Simoyan, Olapeju M.; McCall, Kenneth L.; Nichols, Stephanie D.

doi:10.1016/j.amepre.2018.01.034

Cited by 98 publications

(258 citation statements)

References 37 publications

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“…Opioids for an OUD increased over ninety-percent. Nationwide, prior findings conducted either by the CDC 16 or using ARCOS 5 have found that prescription opioids for pain peaked around 2011 and have subsequently been declining. 17 The rapid population growth in Texas may have delayed the temporal inflection point when more cautious opioid use for chronic non-cancer pain became evident.…”

Section: Discussionmentioning

confidence: 99%

“…10 Oxycodone, by MMEs, was employed almost threefold more than hydrocodone nationally. 5 Texas has the unfortunate distinction of leading the country for most uninsured. 24 The opioid epidemic has been described as iatrogenic.…”

Section: Discussionmentioning

confidence: 99%

“…4 Texas ranked 46 th in the US for per capita morphine mg equivalents (MME, 578) for ten prescription opioids and was approximately one-quarter the highest state (Rhode Island = 2,624). 5 Texas had a similar ranking (45 th ) for buprenorphine and methadone for Opioid Use Disorder (OUD) treatment. 5 Per capita calculations based on US Census data with the total population estimates should be interpreted with caution as undercounting, estimated at 239,500 in 2010 in Texas, may disproportionately impact minorities.…”

Section: Introductionmentioning

confidence: 99%

“…5 Texas had a similar ranking (45 th ) for buprenorphine and methadone for Opioid Use Disorder (OUD) treatment. 5 Per capita calculations based on US Census data with the total population estimates should be interpreted with caution as undercounting, estimated at 239,500 in 2010 in Texas, may disproportionately impact minorities. 6 There are several policy changes and demographic characteristics which may contribute to the rates of prescription opioid use and misuse.…”

Section: Introductionmentioning

confidence: 99%

“…https://doi.org/10.1101/19004879 doi: medRxiv preprint Ten prescription opioids were selected based on prior research. 5,11 Eight of these (hydrocodone, oxycodone, fentanyl, morphine, hydromorphone, oxymorphone, codeine and meperidine) are primarily used to relieve pain, and two (buprenorphine and methadone) are employed for an OUD. A high correspondence between ARCOS and a state prescription monitoring program for oxycodone (r = 0.99) was recently reported.…”

mentioning

confidence: 99%

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Dynamic Changes in Prescription Opioids from 2006 to 2017 in Texas

Ighodaro

McCall

Chung

et al. 2019

Preprint

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Study Objective: The US is experiencing an epidemic of opioid overdoses which may be at least partially due to an over-reliance on opioid analgesics in the treatment of chronic non-cancer pain and subsequent escalation to heroin or illicit fentanyl. As Texas was reported to be among the lowest in the US for opioid use and misuse, further examination of this state is warranted. Study Design: This study was conducted to quantify prescription opioid use in Texas. Data Source: Data was obtained from the publically available US Drug Enforcement Administration Automation of Reports and Consolidated Orders System (ARCOS) which monitors controlled substances transactions from manufacture to commercial distribution. Results: Data for 2006 to 2017 from Texas for ten prescription opioids including eight primarily used to relieve pain (codeine, fentanyl, hydrocodone, hydromorphone, meperidine, morphine, oxycodone, oxymorphone) and two (buprenorphine and methadone) for the treatment of an Opioid Use Disorder (OUD) were examined. The change in Morphine Mg Equivalent (MME) of all opioids (+23.3%) was only slightly greater than the states population gains (21.1%). Opioids used to treat an OUD showed pronounced gains (+90.8%) which were four-fold faster than population growth. Analysis of individual agents revealed pronounced elevations in codeine (+387.5%), hydromorphone (+106.7%), and oxycodone (+43.6%) and a reduction in meperidine (-80.3%) in 2017 relative to 2006. Methadone in 2017 accounted for a greater portion (39.5%) of the total MME than hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, and meperidine, combined. There were differences between urban and rural areas in the changes in hydrocodone and buprenorphine. Conclusions: Collectively, these findings indicate that continued vigilance is needed in Texas to appropriately treat pain and an OUD while minimizing the potential for prescription opioid diversion and misuse. Texas may lead the US in a return to pre opioid crisis prescription levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Dynamic Changes in Prescription Opioids from 2006 to 2017 in Texas

Ighodaro

McCall

Chung

et al. 2019

Preprint

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Association of Electronic Prescribing of Controlled Substances With Opioid Prescribing Rates

et al. 2020

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Key Points Question Have states with greater increases in electronic prescribing of controlled substances (EPCS), which is intended to reduce opioid prescribing rates by reducing fraud and facilitating decision support, experienced greater reductions in opioid prescribing? Findings In this longitudinal analysis of Surescripts reports on the use of EPCS and Center of Disease Prevention and Control opioid prescribing rate maps, increasing the use of EPCS by 10 percentage points was associated with 2 more opioid prescriptions per 100 persons and 0.8% more morphine milligram equivalents. Meaning The EPCS has not been associated with reductions in opioid prescribing rates, and achieving benefit may require greater integration and effective presentation of data.

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Changes in Buprenorphine and Methadone Supplies in the US During the COVID-19 Pandemic

2022

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IMPORTANCEThe opioid crisis has been exacerbated by the COVID-19 pandemic in the US, with concerns over major disruptions to medication treatment of opioid use disorder. OBJECTIVE To investigate whether the COVID-19 pandemic was associated with disruption of buprenorphine and methadone supplies in the US. DESIGN, SETTING, AND PARTICIPANTS This repeated cross-sectional study used ARCOS (Automated Reports and Consolidated Ordering System) data, which monitor the flow of controlled substances in the US, from January 1, 2012, through June 30, 2021. Manufacturers and point of sale or distribution at the dispensing or retail level, including hospitals, retail pharmacies, clinicians, midlevel clinicians, and teaching institutions, were included in the analysis. EXPOSURES COVID-19 pandemic. MAIN OUTCOMES AND MEASURES Quarterly supplies of buprenorphine and methadone per capita in milligrams. RESULTSThe per capita supply of methadone dropped from 13.2 mg in the first quarter of 2020 to 10.5 mg in the second quarter of 2020, whereas the per capita supply of buprenorphine increased from 3.6 mg to 3.7 mg in the same period. The per capita supply of methadone declined 20% (−2.7 mg) in the second quarter of 2020 compared with the first quarter of 2020, and the supply had not returned to 2019 levels as of June 2021, whereas the supply of buprenorphine per person increased consistently during the same period. There were considerable state disparities in the reduction of the methadone supply during the pandemic, with many states experiencing pronounced per capita supply decreases, including reductions as great as 50% in New Hampshire and Florida. These decreases in per capita methadone supply were not compensated by proportional increases in the per capita buprenorphine supply (linear fit, 0.17 [95% CI, −0.43 to 0.76]; P = .47). CONCLUSIONS AND RELEVANCEThis cross-sectional study of buprenorphine and methadone supplies during the COVID-19 pandemic found a pronounced decline in the methadone supply but no disruption to the buprenorphine supply. Future research is needed to explain the pronounced state disparities in the methadone supply.

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Trends in Medical Use of Opioids in the U.S., 2006–2016

Cited by 98 publications

References 37 publications

Dynamic Changes in Prescription Opioids from 2006 to 2017 in Texas

Dynamic Changes in Prescription Opioids from 2006 to 2017 in Texas

Association of Electronic Prescribing of Controlled Substances With Opioid Prescribing Rates

Changes in Buprenorphine and Methadone Supplies in the US During the COVID-19 Pandemic

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