With entire aisles and pharmacy chains devoted to providing you with the latest in health care treatment, it’s not surprising that the United States is teeming with an overabundance of painkillers. While over the counter aids like Advil and Tylenol likely won’t cause an issue for most people, overuse of stronger pain meds have caught the attention of health experts and of bosses nationwide. The misuse of those painkillers can not only lead to a loss of productivity at work, but also to more serious issues including depression, addiction, and overdoses.
Opioid painkillers, including Vicodin and Percocet, can be prescribed by doctors for pain following a surgical procedure or other high-strain condition. But as more research has been conducted about those painkillers, it’s becoming more evident of the problems those medications can cause if they are misused. CNBC reports that opioid abuse costs the U.S. economy about $60 billion per year, with about half that coming from productivity loss and other work-related issues. One study in Indiana found that about 80% of the state’s employers were negatively impacted by prescription drug misuse, and the study’s authors told CNBC they would expect a similar rate in other states across the country.
The problems with opioid painkillers
Another study from Saint Louis University found that the overuse of opioid painkillers for long periods of time held a significantly greater risk for developing major depression. And though depression is a serious medical condition, what concerns the Centers for Disease Control and Prevention most is the rising number of overdose deaths across the country. According to the CDC, opioid overdoses have quadrupled in the United States since 2000, with prescription painkillers as the cause in at least half of those cases. The CDC also states opioid prescription drugs act as a gateway to heroin use. People who are addicted to prescription opioids are 40 times more likely to become addicted to heroin as well.
Though many states are addressing the issue, each one has different regulations about when an opioid painkiller should be prescribed, and how much of the medication should be given at a time. As a result, the rates at which doctors prescribe these painkillers varies widely from state to state, with some states prescribing opioids three times as much as others. According to the CDC, this has little to do with the actual health needs of the citizens in those states, and more to do with the regulations in place. “Such wide variations are unlikely to be attributable to underlying differences in the health status of the population,” the CDC concluded in one analysis of prescription practices. “High rates indicate the need to identify prescribing practices that might not appropriately balance pain relief and patient safety.”
In most cases, the prescription painkiller is a problem because access to the drugs is widespread. In about 55% of cases of prescription drug abuse, the person got those painkillers from a relative or friend for free. Another 20% receive multiple prescriptions from different doctors, which is why some states are implementing online databases for tracking dispensed prescriptions.
States with most prescription painkillers
So which states are at the highest risks for prescription drug abuse? In most cases, it’s the states that have the highest number of prescriptions given in the first place. The CDC put together the map above, showing the range of prescriptions given across the United States. As the map shows, states in the southeast part of the country dole out the most prescriptions.
Here are the 10 states with the most prescriptions, according to data from IMS Health and the CDC from the latest prescription audit in 2012. Each number is per 100 residents.
- Alabama: 143 prescriptions per 100 people
- Tennessee: 143
- West Virginia: 138
- Kentucky: 128
- Oklahoma: 128
- Mississippi: 120
- Louisiana: 118
- Arkansas: 116
- Indiana: 109
- Michigan: 107
Though we can’t draw a clear line from the states with the highest rate of prescriptions to those with the most serious health concerns, there is some evidence it definitely plays a part. West Virginia had the highest rates of drug overdoses in 2014 and 2013, and is the state with the third-highest rate of prescriptions in the country.
The numbers don’t have to be so high, however. States like Hawaii and California — with the lowest prescription rates in the country — give out 52 and 57 prescriptions per 100 people, respectively. That’s almost three times fewer than the numbers in Alabama and Tennessee.
What causes prescriptions to be handed out like candy in the first place? Some lawmakers who would like to change the system blame pharmaceutical companies — and also say it’s the reason the federal government hasn’t moved to make any significant changes either. “The states are going to lead on this one because Big Pharma has too much power,” Peter Shumlin, the governor of Vermont, told The New York Times. Vermont is considering legislation that would restrict the number of pain pills a doctor can prescribe after surgery or an injury. Massachusetts already passed such a bill, limiting those types of prescriptions to a seven-day supply.
In March 2016, the CDC released new guidelines for opioid prescriptions, which encourage doctors to try non-opioid drugs for patients first, and start with the lowest effective dose possible when opioids are prescribed.