Pharmaceutical Research

States with longstanding opioid prescription monitoring programs have fewer outpatient prescriptions for opioid analgesics

Use of opioid analgesics such as morphine and oxycodone, which are typically used for postoperative and other severe pain, increased steadily from 1990 to 2002. Because of their potential for abuse and addiction, opioid analgesics are regulated under Federal laws as Schedule II controlled substances. States vary substantially in the number of prescriptions for Schedule II oral opioid analgesics and specifically for controlled-release oxycodone. However, States with longstanding opioid prescription monitoring programs have the lowest rates of outpatient prescriptions for opioid analgesics, according to a new study. Some States, for example, require the physician to save duplicate copies of these prescriptions.

The study was conducted by researchers at the Center for Education and Research on Therapeutics at the University of Arizona Health Sciences Center, which is supported by the Agency for Healthcare Research and Quality (HS10385). They measured the prevalence of outpatient claims for opioid analgesics and controlled-release oxycodone at the State level based on the drug claims database of a national pharmaceutical benefit manager for nearly 8 million people in 2000. They also examined factors related to opioid analgesic claims at the county level.

A total of 567,778 claims (64.2 per 1,000 claims) were for oral opioid analgesics. Claim rates by State ranged from fewer than 20 to more than 100 claims per 1,000 total claims. In the county-level data, presence of a State-wide opioid prescription monitoring program and proportions of the population aged 15 to 24 and 65 years and older were independently and negatively associated with claim rates for all opioid analgesics. Surgeons per 1,000 claims, the proportion of the population reporting illicit drug use, and the proportion who were female were independently and positively associated with claim rates for all opioid analgesics. Only the proportion of the population aged 25 to 32 and number of surgeons per 1,000 claims were independently and positively associated with claim rates for oxycodone.

More details are in "Geographic variation in the prescription of schedule II opioid analgesics among outpatients in the United States," by Lesley H. Curtis, M.S., Ph.D., Jennifer Stoddard, M.S., Jasmina I. Radeva, M.A., and others, in the June 2006 HSR: Health Services Research 41(3), pp. 837-855.

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