Study Finds Urban Missouri Areas Have Higher Prescriptions of High-Dose Opioids

Researchers from the University of Missouri School of Medicine have examined the patterns of high-dose opioid prescriptions across different populations in Missouri. Their study reveals that individuals living in urban areas are more likely to receive prescriptions for higher opioid doses, which subsequently increases their risk of developing opioid use disorder (OUD). Opioids such as hydrocodone and oxycodone are commonly prescribed to manage intense pain, but their use carries significant risks including tolerance, dependence, and overdose, even when taken as directed.

The study emphasizes that factors like the severity of pain, duration of opioid use, and the presence of mental health conditions contribute to these risks. To identify populations most vulnerable, the researchers analyzed over 3 million Medicaid claims from 2017 to 2021, involving 306,432 records compared against census data and healthcare access information. The findings showed that male patients and those up to 60 years old were more frequently prescribed high opioid doses. Conversely, prescribing patterns for younger adults were more conservative, likely due to increased awareness surrounding the opioid epidemic.

Additionally, the study observed that older adults beyond age 60 had a sharp decline in high-dose prescriptions, potentially due to heightened concerns over adverse effects and drug interactions. The analysis also found that urban regions with higher rates of veterans and primary care providers exhibited greater risks of high-dose prescribing.

These insights underscore the urgent need for targeted public health strategies to mitigate the opioid crisis. Education programs for healthcare providers, such as the Show Me ECHO initiative, aim to promote evidence-based pain management and opioid use disorder treatments. While current guidelines recommend avoiding high-dose prescriptions, they remain prevalent in certain areas. However, since the study focused solely on Missouri, the applicability of these findings to other states may be limited. Further research is necessary to understand long-term trends and the reasons behind high-dose prescriptions.

Mirna Becevic, Ph.D., an assistant professor at MU School of Medicine specializing in telemedicine, highlights that demographic factors and healthcare access significantly influence prescribing behaviors. Addressing these risk factors is crucial for improving opioid safety and reducing overdose risks.

This study and its findings contribute valuable knowledge to combating opioid misuse and highlight the importance of tailored public health interventions in urban settings.