In a recent study, researchers found where people live may determine how many opioids they can get.
For example, people who sought care for a sprained ankle in states that are “high prescribers” of opioids were three times more likely to get a prescription for opioids than people in “low-prescribing” states.
The research was conducted by a team from Penn Medicine.
Previous studies have shown that opioid abuse and addiction has become a serious public health issue.
In the current study, the team examined private insurance claims data from more than 30,800 people who visited U.S. emergency departments for an ankle sprain from 2011-2015.
They found that overall, about 25% of patients received a prescription for an opioid painkiller, even though opioids are not the first-line treatment for the health condition.
In total, more than 143,000 opioid tablets were prescribed for patients.
Moreover, there was wide variation across states in opioid prescription. The high prescribing states offer opioids much more easily to patients than the low prescribing states.
For instance, only 3% of patients received an opioid prescription in North Dakota, compared to 40% in Arkansas.
In addition, the team found when patients received opioid prescriptions for long courses (e.g. more than 30 tablets of oxycodone 5 mg), they were five times more likely to fill additional opioid prescriptions over the next 6 months than those who received just a few days’ supplies.
The findings suggest wide geographic variability in prescribing patterns for minor injuries.
The team suggests it is important to reduce the size of new, initial opioid prescriptions, which can increase the risk of prolonged opioid use.
If opioids are absolutely necessary, doctors should prescribe the lowest initial dose possible, which should be no more than 10-12 tablets.
In addition, there should be more specific opioid and non-opioid prescription guidelines.
It is also important to find better non-opioid alternatives for pain management of minor injuries.
The lead author of the study is M. Kit Delgado, MD, MS, an assistant professor of Emergency Medicine and Epidemiology at Penn.
The study is published in the Annals of Emergency Medicine.
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