The district level of opioid delivery rates influences abuse at the individual level

December 27, 2021

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According to the results of the study published in the American Journal of Psychiatry, researchers found a direct link between the rate of dispensing of opioids at the district level and the abuse of prescription opioids at the individual level, the frequency and dependency of abuse.

“Relying on national data from the CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA), this study builds on previous research to directly examine the relationship between district-level opioid delivery rates and individual pharmaceutical opioid abuse and heroin use and addiction,” Mike Vuolo, PhD, the Department of Sociology at Ohio State University and Brian C. Kelly, PhD, of the Department of Sociology at Purdue University, wrote. “The results can have an impact not only on prevention and intervention, but also on clinical practice.”

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In particular, Vuolo and Kelly analyzed data from the restricted-access National Survey on Drug Use and Health, the CDC’s retail opioid prescription database, the Prescription Drug Abuse Policy System, and the US Census. They used fixed-effect models to examine whether delivery rates at the district level affected prescription opioid outcomes as intended, and whether rate changes adversely affected heroin use outcomes. They comprised 748,000 participants aged 12 years or older between 2006 and 2016.

The results showed an increased risk of prescription opioid abuse, an increased frequency of abuse, and a dependency of 7.2%, 3.5% and 10.4% per standard deviation increase in the opioid delivery rate at the district level per 100 people. The researchers saw no evidence of an association between opioid delivery rates and the three heroin outcomes.

“Institutional changes in prescribing physicians, possibly shaped by both professional recognition of the problem and policy implementation, may have helped contain the prescription opioid crisis; However, these changes appear to have changed heroin use (in any direction) following shifts in dispensing at the county level, ”wrote Vuolo and Kelly. “We recommend that medical providers continue to monitor prescribing and dispensing patterns and that states continue to have policies that mitigate unnecessary opioid prescriptions.”

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Opioid Resource Center

Opioid Resource Center

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