pills-384846_960_720-300x200-4567758Opioid prescribing rates vary widely across New York, with residents in some counties receiving three or four times as much of the potentially addictive pain relievers as in other counties, according to new data from the U.S. Centers for Disease Control.

The CDC found similar disparities across the country, and said they were a potential sign of doctors failing to follow up-to-date guidelines for when and how to use opioids for pain treatment.

Given associations between opioid prescribing, opioid use disorder, and overdose rates, health care providers should carefully weigh the benefits and risks when prescribing opioids outside of end-of-life care, follow evidence-based guidelines … and consider nonopioid therapy for chronic pain treatment.

In New York, the highest prescribing rate for 2015 was in the Catskill region’s Sullivan County, at 1,182 morphine milligram equivalents (MME) per capita. That was more than four times the rate in Brooklyn, which was lowest at 272 MME per capita.

The nationwide results were published last week in the CDC’s Morbidity and Mortality Weekly Report. The agency provided county-by-county details for New York at the request of the Empire Center.

The national average prescribing rate of 640 MME per capita is down about 18 percent since its peak in 2010, but still three times higher than it was in 1999.

New York’s prescribing rates are substantially lower than the U.S. average and also declining. The weighted average among the state’s counties (as estimated by the Empire Center) was about 539 MMEs per capita in 2015, down from 604 in 2010.

The five highest-prescribing counties were mainly small and rural and scattered across upstate: Sullivan, Chemung, Warren, Niagara, and Chautauqua. The five lowest-prescribing counties, with one exception, were larger and concentrated downstate: Kings, Queens, Westchester, Lewis, and the Bronx.

Among the 62 counties, 23 saw a significant decrease in the their prescribing rates from 2010 to 2015, 17 saw a significant increase, and 21 were stable, according to the CDC’s analysis. There was no available data for Hamilton County, the state’s smallest by population.

Interestingly, the counties that saw the biggest percentage increases were concentrated in the North Country: Lewis, Saint Lawrence, Franklin, Jefferson, and Clinton. The biggest percentage decreases were in Genesee, Yates, Chenango, Monroe, and Suffolk.

Nationally, the CDC found that prescribing rates tended to be higher in counties with a larger population of non-Hispanic whites, with a higher prevalence of diabetes and arthritis, and with higher rates of unemployment and Medicaid enrollment.

Within New York, however, prescribing rates do not seem to correlate with overdose deaths. Some counties, such as Staten Island, ranked high for both opioid prescriptions and overdoses (12th and 1st, respectively). But Warren County, with the third-highest prescribing rate in 2015, ranked 45th for its overdose rate in 2016. The Bronx, on the other hand, ranked 57th for prescribing but seventh for overdoses.

A chart of county-by-county prescribing rates and overdose deaths is available here.

 

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

While New York’s Medicaid Budget Soared, Public Health Funding Languished

Four years after a devastating pandemic, the state has made no major investment to repair or improve its public health defenses. While funding for Medicaid over the past four years Read More

A Medicaid Grant Recipient Sponsors a Pro-Hochul Publicity Campaign

While much of the health-care industry is attacking Governor Hochul's Medicaid budget, at least one organization is rallying to her side: Somos Community Care, a politically active medical group in the Bronx that recently r Read More

Loss of Patients and Revenue Foreshadowed Downsizing for SUNY Downstate

The SUNY-owned hospital in Brooklyn facing a newly announced downsizing plan has seen its patient volume and revenue plunge over the past decade, according to a review of its financial reports. Read More

How a Medicaid Program To Improve Nursing Home Care Ended Up Paying for Union Benefits

New York State's budget-making process sometimes works like a closed loop, as interest groups on the receiving end of state spending reinvest a portion of their proceeds to lobby Albany for still more money. Read More

Despite Lingering Shortages, New York’s Health-Care Workforce Is Bigger Than Ever

The state's health-care workforce is recovering unevenly from the pandemic, with persistently lower employment levels in some areas and robust growth in others. This mixed pattern c Read More

The Wacky Math of New York’s Essential Plan

Thanks to an absurdly wasteful federal law, New York's Essential Plan is expected to continue running billion-dollar surpluses even as state officials more than double its spending over the next several years. Read More

In a Tight Budget Year, New York’s Hospital Lobby Shoots for the Moon

As Governor Hochul calls for spending restraint next year, influential hospital lobbyists are pushing what could be the costliest budget request ever floated in Albany. In a , the G Read More

Putting the Mission in Hochul’s Health Commission

Last week Governor Hochul answered one big question about her Commission on the Future of Health Care – the names of its members – but left a fundamental mystery unresolved:  W Read More