Patterns of Opioid Prescribing in Minnesota: 2012 and 2015

Publisher: Saint Paul, MN: Minnesota Department of Health, Health Economics Program
Apr 30, 2018
Authors
Jiaqi Li, Thomas Bell, and Deborah Chollet

Key Findings:

  • Overall rates of opioid prescribing declined in Minnesota from 2012 to 2015, but the morphine milligram equivalents (MME) per prescription increased.
  • Medicare and Medicaid, where eligibility is determined by age, disability status, and/or income, covered approximately one-third of Minnesotans with general health coverage and accounted for two-thirds of opioid prescriptions filled in 2015.
  • Nearly one in three Minnesotans with an opioid prescription in 2015 had multiple prescribers.
  • In both 2012 and 2015, 6 in 10 opioid prescriptions were filled within 15 days of the patient’s last medical visit; however, 1 in 10 opioid prescriptions were filled without a medical visit in the past 90 days, suggesting closer patient-prescriber communication or opioid oversight may be needed in some cases.
  • Prescription opioid use varied across counties. In some counties, prescription opioid use in 2015 was over 3 times the statewide average of 523 MME per resident.

Opioids are a class of drugs that include prescription opioid medications for pain relief —such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and fentanyl—as well as illicitly produced drugs like heroin and fentanyl-related substances (also called fentanyl analogs). While prescription opioids play a role in the management of some types of severe acute, cancer-related and end-of-life pain, increased opioid use since 1990, including for chronic pain unrelated to cancer, has resulted in sharply rising opioid addiction and overdoses, as well as increased healthcare utilization and costs. Recent Centers for Disease Control and Prevention (CDC) guidelines point out the limitations of the evidence base in support of opioid therapy for pain, recommend non-opioid therapy for chronic pain, and emphasize the risks associated with opioid therapy. In Minnesota, opioids—both prescription and illicit—were responsible for 336 overdose deaths in 2015, more than a six-fold increase since 2000. In 2016, opioid use accounted for 395 overdose deaths in Minnesota—a one-year increase of nearly 18 percent. Forty-nine percent of the opioid overdose deaths in Minnesota in 2016 were from prescription opioids. In addition to overdose deaths, opioids play a causal role in other deaths, including automobile accidents.