New county-level data from the CDC highlight the extreme geographic variation in opioid prescription rates, with some areas showing average morphine equivalents per capita 10 times greater than those of less-impacted counties.
In a conference call with reporters, CDC Acting Director Anne Schuchat said, across the country, there are still too many people getting opioid prescriptions for too many days at too high a dose. Opioids are to be used for chronic pain which lasts for three months or more says the guidelines.
A new study of opioid prescriptions filled at a Johns Hopkins Medicine outpatient pharmacy found that handwritten orders for the drugs contribute heavily to a trio of prescribing and processing errors in contrast to those created electronically.
Between 2006 and 2015, the amount of opioids prescribed peaked in 2010 at 782 morphine milligram equivalents per person and decreased to 640 in 2015.
The high amount of opioids prescribed is continuing to drive drug overdoses and drug overdose deaths, she said.
The duration of the prescriptions also increased, from 13 days in 2006 to 18 days in 2015.
Overall, the analysis found that the amount of opioids prescribed fell 18 percent from 2010-2015, though it increased in 23 percent of the counties.
"The amount of opioids prescribed in 2015 was enough for every American to be medicated around the clock for three weeks", she said.
In response to the CDC's findings, the American Medical Association said in a statement that the country must do more to provide evidence-based, comprehensive treatment for pain and for substance use disorders.
Prescribe opioids only when benefits outweigh risks.
But earlier actions, like state crackdowns on pain clinics and prescribing guidelines released by the Department of Veterans Affairs in 2010, may have contributed to the declines.
"The thinking on opioid prescribing has changed in recent years as the severity of the risks of the drugs has come to light", Avitzur says. Customers of Cigna Health Insurance, for instance, have consumed almost 12 percent fewer opioids in the past year, according to Will Lopez, senior medical director of Cigna Behavioral Health. And there is still tremendous regional variation in how many opioids doctors prescribe, with far more prescribed per capita in parts of Maine, Nevada and Tennessee, for example, than in most of Iowa, Minnesota and Texas.
"We're in the midst of the worst drug addiction epidemic in United States history, but we are still massively overprescribing", says Andrew Kolodny, an addiction specialist at Brandeis University in Waltham, Mass.
The Daily News in May chronicled the devastating effects the opioid crisis is having on Staten Island and the Bronx. This year, New Jersey became the strictest, limiting painkiller prescriptions to just five days. The latest numbers from the CDC find that the number of overdoses due to heroin and illicit synthetics are on the rise.
And when prescriptions end, some people move on to stronger illegal drugs. Opioids are derived naturally or synthetically from the opium poppy.
That contrast underlines the dramatic differences in opioid prescribing across the country as health officials try to tackle a national epidemic. "The issue now is that we need more access to treatment".