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Variation in Abuse-Deterrent Formulation Opioid Prescribing in California, Florida, and Kentucky in 2018

NCJ Number
Journal of Rural Health Volume: 37 Issue: 1 Dated: 2020
John R. Brown; Yanning Wang; Sverta Slavova; Chris Delcher; Nabarun Dasgupta; Patricia R. Freeman
Date Published
8 pages
This study characterized abuse-deterrent formulation (ADF) opioid prescribing patterns in three diverse states.
Abuse-deterrent formulation (ADF) opioid analgesics have been developed to address prescription opioid abuse; however, ADF opioid use in clinical practice is not well described in the literature. The current study used data from prescription drug monitoring programs (PDMPs) in California, Florida, and Kentucky. The sample included all ADF opioid prescriptions for patients 18 years old during the study period (CY 2018). Standardized prescribing rates were calculated by age, sex, and county rurality. The ADF opioid prescribing rate was calculated per 1,000 adult recipients of opioid analgesics. The study found that the rate of ADF prescribing per 1,000 adult recipients of opioid analgesics was nearly twice as high in Florida (14.57; 95 percent CI: 14.44-14.69) than in California (8.30; 95 percent CI: 8.22-8.37) or Kentucky (8.20; 95 percent CI: 8.01-8.39). ADF prescribing rates were highest among adults ages 55-74 years old and among males. ADF opioid prescribing in rural counties represented a greater proportion of total patients using opioid analgesics than in metro counties in California (RR 1.40; CI: 1.28-1.53). Opposite and less pronounced variation was observed in Kentucky (RR 0.93; 95 percent CI: 0.88-0.98), and a significant difference was not observed in Florida (RR 0.68; 95 percent CI: 0.38-1.19). Thus, there were significant differences in the ADF prescribing rates among the three states and in rural versus metro counties within two states. ADF opioid prescribing by age and sex showed similar trends within states. Further research is needed to clarify contextual factors that may lead to prescribing variation. (publisher abstract modified)