Trends in the Distribution of Opioids in Puerto Rico, 1999-2013.
OBJECTIVE
Limited information has been published about opioid prescribing practices in Puerto Rico. The objective of this study was to create baseline trends of opioids distributed over a period of fourteen years in Puerto Rico.


METHODS
We examined data from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System (ARCOS) for the period 1999-2013. ARCOS data reflects the amount of controlled substances legally dispensed. Analyses include the distribution of opioids (in morphine milligram equivalent kg per 10,000 persons) by year and entity (pharmacy, hospital, practitioner).


RESULTS
The distribution of four drugs (fentanyl, hydromorphone, methadone, oxycodone) increased over 100% between 1999 and 2013. The distribution of two drugs (hydrocodone and meperidine) declined between 1999 and 2013. Oxycodone distribution grew from 0.13 MME kg grams per 10,000 persons in 1999 to 0.29 MME kg in 2013.


CONCLUSIONS
ARCOS data showed that the overall amount of opioid pain relievers distributed in Puerto Rico increased by 68% between 1999 and 2013. Currently, prescription opioid pain reliever overdose deaths in Puerto Rico do not appear to be skyrocketing as they are in the mainland U.S. However, the ongoing problem with prescription opioid pain reliever overdoses in certain areas should serve as a warning to monitor consumption of opioid pain relievers, as well as changes in prescription drug abuse, overdoses, and deaths.
Center for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta Georgia, USA.
Sausan
S
El Burai Félix
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Analysis, Research and Practice Integration, Atlanta, Georgia, USA.
Karin A
KA
Mack
Office of Public Health Strategy and Analysis, Office of the Commissioner, Food and Drug Administration, Silver Spring, Maryland.
Christopher M
CM
Jones
D000701:Analgesics, Opioid / Q000600:supply & distribution*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004358:Drug Therapy / Q000639:trends; D006801:Humans; D011647:Puerto Rico; D013997:Time Factors
D000701:Analgesics, Opioid
Overdose; Prescription drugs