Physician Dispensing of Oxycodone and Other Commonly Used Opioids, 2000-2015, United States.
An average of 91 people in the United States die every day from an opioid-related overdose (including prescription opioids and heroin). The direct dispensing of opioids from health care practitioner offices has been linked to opioid-related harms. The objective of this study is to describe the changing nature of the volume of this type of prescribing at the state level.



This descriptive study examines the distribution of opioids by practitioners using 1999-2015 Automation of Reports and Consolidated Orders System data. Analyses were restricted to opioids distributed to practitioners. Amount distributed (morphine milligram equivalents [MMEs]) and number of practitioners are presented.



Patterns of distribution to practitioners and the number of practitioners varied markedly by state and changed dramatically over time. Comparing 1999 with 2015, the MME distributed to dispensing practitioners decreased in 16 states and increased in 35. Most notable was the change in Florida, which saw a peak of 8.94 MMEs per 100,000 persons in 2010 (the highest distribution in all states in all years) and a low of 0.08 in 2013.



This study presents the first state estimates of office-based dispensing of opioids. Increases in direct dispensing in recent years may indicate a need to monitor this practice and consider whether changes are needed. Using controlled substances data to identify high prescribers and dispensers of opioids, as well as examining overall state trends, is a foundational activity to informing the response to potentially high-risk clinical practices.
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Karin Ann
KA
Mack
Office of the Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Washington, DC, USA.
Christopher McCall
CM
Jones
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Roderick John
RJ
McClure
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D061891:Controlled Substances; D062787:Drug Overdose / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006801:Humans; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010098:Oxycodone / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data; D014481:United States
D000701:Analgesics, Opioid; D061891:Controlled Substances; D010098:Oxycodone