NL County has state’s second highest opioid prescribing rate

Your likelihood of getting an opioid prescription varies significantly depending on the county where your prescriber is, according to The Day’s analysis of federal data obtained by the Associated Press.

To draw comparisons, the data, which covers the years of 2010 and 2015, looks at the number of morphine milligram equivalents, or MME, prescribed per capita.

The counties of New Haven and New London lead the pack, despite seeing slight decreases in prescription rates over the five-year span. In 2015, New Haven issued 845.1 MME per person. New London prescribed 819 MME per person.

An easier way to understand the numbers? In New Haven, prescribers handed out enough opioid medications in 2015 to provide every resident with a 17.6-day supply. In New London, each resident’s supply would last 17 days.

It’s possible people are getting prescriptions from one county reside in another. But it puts New Haven and New London above the national aver-

age of 640 MME, or 13.3 days, per person.

In its July report about the numbers, the Centers for Disease Control and Prevention named characteristics its analysis found were associated with higher prescribing. Counties with more non-Hispanic whites, higher rates of Medicaid enrollment, lower educational attainment, higher rates of unemployment and higher prevalence of diabetes, for example, tended to issue more opioids.

That's not necessarily the case in Connecticut.

In 2015, four counties prescribed more than Litchfield, which has the largest non-Hispanic white population.

The least educated county, Tolland, handed out the second-to-lowest number of opioids.

Six counties prescribed more than Hartford, which sees the most Medicaid enrollment.

Of the above listed factors, only unemployment rate returned an apparent correlation: Windham, New Haven and New London came back with the highest unemployment rates while also having the top three highest prescribing rates.

According to Gery P. Guy Jr., corresponding author of the study, all the characteristics researchers flagged accounted for just one-third of the variation from county to county.

That's no small thing considering that the highest-prescribing counties gave out six times as many opioids as the lowest-prescribing ones.

“That was very surprising,” Guy said of discovering just how different prescribing practices are from place to place. “It suggests there's not a consensus on the appropriate use of opioids.”

Connecticut didn't see as much variation as other states. None of its counties, Guy noted, were in the highest or the lowest quartile in terms of prescribing. Still, prescribers in New Haven were almost 77 percent more likely to give out opioids than in neighboring Fairfield, which handed out enough medications to give its residents 9.9-day prescriptions.

For leaders in high-prescribing counties who are wondering what they can do, Guy offered some advice.

Bring in experts who can educate prescribers about best practices. Increase access to medically assisted treatment for patients who are opioid use-dependent and have plenty of overdose-reversing naloxone on hand, too. Pinpoint prescribers who are issuing higher amounts. And encourage all prescribers to lean heavily on prescription drug monitoring programs, which exist in all states but Missouri, whose system is pending.

Guy said he's optimistic opioid prescribing rates in the United States will continue to decrease. There's room for that as the 2015 numbers still were three times higher than 1999's.

“I think there's increased awareness among prescribers and among patients regarding the risks associated with opioid use,” he said, noting that the CDC released guidelines last year regarding the prescribing of opioids for chronic pain.

“I think because of a combination of many factors ... we expect to see continued reductions in prescribing,” Guy said.

According to the CDC's analysis, on average, every 48.1 MME issued was meant to last one day. The Day divided the annual MME per capita data by 48.1 to estimate the average number of days' prescription per person in each county.