A new study says 41 of the 50 cities with the highest prevalence of opioid use are in four states in one U.S. region.
Those states are Kentucky, Alabama, Georgia and Arkansas – all in the southeast, according to the report, A Nation in Pain, from mail-order pharmacy Express Scripts.
Higher opioid use in less populated southern cities could be the result of a variety of factors, including:
- prevalence of chronic and debilitating diseases that impact the southern region of the country, including obesity and diabetes which often have associated pain that may require opioid treatment, and
- less access to clinical care, particularly specialists – opioids may be prescribed more frequently when there are limited care alternatives.
Of the 25 cities with the highest prevalence of longer-term opioid use, 24 have populations below 100,000.
The largest U.S. cities have opioid rates below the national average. However, they have a higher proportion of users taking very high doses of these drugs.
A report earlier this year from the U.S. Centers for Disease Control and Prevention (CDC) showed similar results. In the CDC’s report, the top 5 states for painkiller prescriptions per 100 people in 2012 were Alabama, Tennessee, West Virginia, Kentucky and Oklahoma.
Ups and downs
The report contains both good and bad news regarding consumption of these powerful painkillers in the U.S.
The number of patients filling prescriptions for opioids declined 9.2% between 2009 and 2013.
But the number of prescriptions filled and the number of days of medication per prescription both rose 8.4%.
Some other key findings from the study:
- The number of short-term users declined 11.1% from 2009 to 2013
- Nearly half of patients who took opiate painkillers for more than 30 days in the first year of use continued to use them for three years or longer
- 30% more women than men took prescription opiates in 2013, but men are more likely to fill more prescriptions and take higher doses, and
- Nearly 60% of long-term opioid users take a combination of drugs that are dangerous and potentially fatal. Almost a third were also prescribed anti-anxiety drugs. When combined with opiates, this is the most common cause of overdose deaths involving multiple drugs.
Workers who abuse prescription painkillers are a safety risk to themselves and others, and have lower productivity.
To combat this potential problem, the National Safety Council recommends:
- Educate employees about the dangers of prescription painkillers and their misuse
- Train supervisors about the potential signs of employee drug impairment, and what they should and shouldn’t do if they suspect it (work with HR on this), and
- Let your employees know about resources that may be available through your Employee Assistance Program for help with painkiller dependence.