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A pharmacist counts tablets of Hydrocodone at a pharmacy in Portsmouth, Ohio, June 21, 2017.   REUTERS/Bryan Woolston

Prescription opioids tripled between 1999 and 2015, CDC says

By 2015, doctors in the U.S. weren’t doling out as many opioids as they did in 2010, when more of the drugs were prescribed than at any other time in recent memory. But the sheer volume of opioids prescribed that year was still three times higher than in 1999, according to new government data.

In 2010, the volume of opioids prescribed reached 782 morphine milligram equivalents — the unit that researchers use to measure opioids — per capita. Five years later, while that number had dropped to 640 units, it was still far greater than levels seen in 1999, when 180 units were sold per capita in the U.S.

A new county-by-county analysis from the Centers for Disease Control and Prevention revealed that opioids were prescribed more often in rural communities, among white populations and places with fewer jobs; in counties with higher prevalence of diabetes and arthritis and more Medicaid enrollees. But CDC Acting Director Anne Schuchat said that only explains a small fraction of the variation the CDC found across counties.

Appalachia and the western U.S. reported some of the highest amounts of prescribed opioids, along with parts of upstate New York and southwest Wyoming. But Schuchat said, “there are very few towns, cities or even families that don’t have some connection to the opioid problem, and we feel there’s a lot we can do together.”

Researchers studied data from more than 59,000 pharmacies, accounting for nearly nine out of 10 prescriptions nationwide. Based on its analysis, the CDC says more than 2 million Americans who consumed prescription opioids had an opioid use disorder. The disease’s overall economic burden — such as the cost of substance abuse treatment, health care and legal cases — cost the U.S. more than $78 billion a year.

The data shows public health officials and the nation “have more work to do,” Schuchat said.

“With opioid medications, we’re still seeing too many getting too much for too long,” she said. “The amount of opioids prescribed in 2015 was enough for every American to be medicated around the clock for three weeks.”

At the same time, half of all U.S. counties saw a significant drop in opioid prescriptions, including large swaths of Ohio, Indiana, Kentucky and Florida. The report gave some of the credit for that decrease to prescription drug monitoring programs that track how often and in what quantities clinicians prescribed opioids.

The report highlights the opioid epidemic’s ongoing fallout nationwide. Despite reductions in prescription opioids, the CDC pointed to the increased use of illicit opioids, such as heroin and fentanyl, for the rise in lethal drug overdoses.

“There is no evidence that policies designed to reduce inappropriate opioid prescribing are leading to these increases,” the report said.

The latest estimates suggest fatal drug overdoses spiked in 2016 with more than 59,000 deaths, surpassing previous years, according to analysis from the New York Times. The CDC has not made public its data for that year. In 2015, the latest year for available federal data, more than 52,400 people died after overdosing on drugs. Of those, nearly two-thirds involved opioids, including 15,000 deaths linked to prescription opioids, the CDC reported.

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In 2016, the CDC implemented new guidelines to physicians for prescribing opioids for chronic pain, including alternatives to opioids. Schuchat said the 2015 data served as a baseline and that it is too early to know the impact of the new opioid guidelines.

President Donald Trump signed an executive order in March thatestablished an opioid commission to study the crisis. The commission, chaired by New Jersey Gov. Chris Christie, met for the first time in June but has since missed its deadline to produce a preliminary set of recommendations about how the nation needs to move forward.