title: Distance traveled and frequency of interstate opioid dispensing in opioid shoppers and nonshoppers.
abstract: Little is known about how far opioid shoppers travel or how often they cross state lines to fill their opioid prescriptions. This retrospective cohort study evaluated these measures for opioid shoppers and nonshoppers using a large U.S. prescription database. Patients with ≥3 opioid dispensings were followed for 18 months. A subject was considered a shopper when he or she filled overlapping opioid prescriptions written by >1 prescriber at ≥3 pharmacies. A heavy shopper had ≥5 shopping episodes. Outcomes assessed were distance traveled among pharmacies and number of states visited to fill opioid prescriptions. A total of 10,910,451 subjects were included; .7% developed any shopping behavior and their prescriptions accounted for 8.6% of all opioid dispensings. Shoppers and heavy shoppers were younger than the nonshoppers. Shoppers traveled a median of 83.8 miles, heavy shoppers 199.5 miles, and nonshoppers 0 miles. Almost 20% of shoppers or heavy shoppers, but only 4% of nonshoppers, visited >1 state. Shoppers traveled greater distances and more often crossed state borders to fill opioid prescriptions than nonshoppers, and their dispensings accounted for a disproportionate number of opioid dispensings. Sharing of data among prescription-monitoring programs will likely strengthen those programs and may decrease shopping behavior.
  
  
  CONCLUSIONS
  This study shows that opioid shoppers travel greater distances and more often cross state borders to fill opioid prescriptions than nonshoppers, and their dispensings accounted for a disproportionate number of opioid dispensings. The findings support the need for data sharing among prescription-monitoring programs to deter opioid shopping behavior.
authors.affiliation: Department of Epidemiology, Janssen Research & Development, Titusville, New Jersey. Electronic address: scepeda@its.jnj.com.
authors.forename: M Soledad
authors.initials: MS
authors.lastname: Cepeda
authors.forename: Daniel
authors.initials: D
authors.lastname: Fife
authors.forename: Yingli
authors.initials: Y
authors.lastname: Yuan
authors.forename: Greg
authors.initials: G
authors.lastname: Mastrogiovanni
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid; D015331:Cohort Studies; D016208:Databases, Factual; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology; D010594:Pharmacies; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014195:Travel / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid
keywords: Opioids; doctor shopping; opioid abuse; opioid diversion; prescription-monitoring programs