Opioid Overdose

Sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014,1 but there has not been an overall change in the amount of pain Americans report.2,3 During this time period, prescription opioid overdose deaths increased similarly.

The supply of prescription opioid pain relievers remains high in the U.S.4 An estimated 1 out of 5 patients with non-cancer pain or pain-related diagnoses are prescribed opioids in office-based settings.3 From 2007 – 2012, the rate of opioid prescribing has steadily increased among specialists more likely to manage acute and chronic pain. Prescribing rates are highest among pain medicine (49%), surgery (37%), and physical medicine/rehabilitation (36%). However, primary care providers account for about half of opioid pain relievers dispensed. 3

Health care providers, including those in primary care settings, report concern about opioid-related risks of addiction and overdose, as well as insufficient training in pain management. Although prescription opioids can help manage some types of pain, there is not enough evidence that opioids improve chronic pain, function, and quality of life. Moreover, long-term use of opioid pain relievers for chronic pain can be associated with abuse and overdose, particularly at higher dosages.

Prescription Opioid Use Among Subgroups

Prescription opioid use varies according to age, gender, and ethnicity:

  • Older adults (aged 40 years and older) are more likely to use prescription opioids than adults aged 20 – 39.
  • Women are more likely to use prescription opioids than men.
  • Non-Hispanic whites are more likely to use prescription opioids than Hispanics. There are no significant differences in prescription opioid use between non-Hispanic whites and non-Hispanic blacks.5,6

State-to-State Variability

Prescribing rates for opioids vary widely across different states. In 2012, health care providers in the highest-prescribing state wrote almost 3 times as many opioid painkiller prescriptions per person as those in the lowest prescribing state.4 Health issues that cause people pain do not vary much from place to place, and do not explain this variability in prescribing. Some other factors that may influence prescribing rates include:

  • Health care providers in different parts of the country don’t agree on when to prescribe opioid painkillers and how much to prescribe.
  • Some of the increased demand for prescription opioids is from people who use them nonmedically (using drugs without a prescription or just for the high they cause), who sell them, or who obtain them from multiple prescribers.
  • Many states report problems with for-profit, high-volume pain clinics (so-called “pill mills”) that prescribe large quantities of painkillers to people who don’t need them medically.


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