ArticleThe journal of pain2012
Geographic variation in opioid prescribing in the U.S.
Article in The journal of pain, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 145 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
145 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The opioid and related drug epidemics in rural Appalachia: A systematic review of populations affected, risk factors, and infectious diseases.Substance abuse · 2020Pooled it
- Opioid Prescribing Patterns and Complications in the Dermatology Medicare Population.JAMA dermatology · 2018Pooled it
- Correlates of Long-Term Opioid Abstinence After Randomization to Methadone Versus Buprenorphine/Naloxone in a Multi-Site Trial.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2018Trial
- Buprenorphine utilization following removal of prior authorization requirements in the Kentucky Medicaid population.Drug and alcohol dependence · 2026Article
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- Article
- What Drives Risky Prescription Opioid Use?: Evidence from Migration.The quarterly journal of economics · 2025Article
- Opioid use in postoperative pain management of pediatric appendectomy patients in Japan.Journal of anesthesia · 2025Article
- Psychological Distress and Cognitive Function in Women: Exploring Potential Mediation by Use of Opiates, Sleep Aids, or Minor Tranquilizers.Journal of women's health (2002) · 2025Article
- Implementation of Medication Disposal Programs and Availability of Same-Day Naloxone at Community Pharmacies: Protocol for a Secret Shopper Caller Approach.JMIR research protocols · 2025Article
- Medication disposal within reach: Assessing implementation of permanent disposal receptacles in community pharmacies.Drug and alcohol dependence · 2025Article
- Article
- Postoperative Opioid Administration and Prescription Practices Following Hysterectomy in Two Tertiary Care Centres: A Comparative Cohort Study between Canada and Austria.Journal of clinical medicine · 2024Article
- Risk of prolonged postoperative opioid use after elective shoulder replacement: a nationwide cohort study of 5,660 patients from the Danish Shoulder Arthroplasty Registry.Acta orthopaedica · 2024Article
- Association of Opioid Use Disorder Diagnosis with Management of Acute Low Back Pain: A Medicare Retrospective Cohort Analysis.Journal of general internal medicine · 2024Article
- The association between primary care appointment lengths and opioid prescribing for common pain conditions.BMC health services research · 2024Article
- Managing an epidemic within a pandemic: orthopedic opioid prescribing trends during COVID-19.Archives of orthopaedic and trauma surgery · 2024Article
- Drug disposal deserts: An assessment of receptacle availability in Kentucky community pharmacies.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- Prescription opioids and economic hardship in France.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- State-to-State Variation in Opioid Dispensing Changes Following the Release of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.JAMA network open · 2023Article
85 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
unlabelledEstimates of geographic variation among states and counties in the prevalence of opioid prescribing are developed using data from a large (135 million) representative national sample of opioid prescriptions dispensed during 2008 by 37,000 retail pharmacies. Statistical analyses are used to estimate the extent to which county variation is explained by characteristics of resident populations, their healthcare utilization, proxy measures of morbidity, availability of healthcare resources, and prescription monitoring laws. Geographic variation in prevalence of prescribed opioids is large, greater than the variation observed for other healthcare services. Counties having the highest prescribing rates for opioids were disproportionately located in Appalachia and in southern and western states. The number of available physicians was by far the strongest predictor of amounts prescribed, but only one-third of county variation is explained by the combination of all measured factors. Wide variation in prescribing opioids reflects weak consensus regarding the appropriate use of opioids for treating pain, especially chronic noncancer pain. Patients' demands for treatment have increased, more potent opioids have become available, an epidemic of abuse has emerged, and calls for increased government regulation are growing. Greater guidance, education, and training in opioid prescribing are needed for clinicians to support appropriate prescribing practices. PERSPECTIVE: Wide geographic variation that does not reflect differences in the prevalence of injuries, surgeries, or conditions requiring analgesics raises questions about opioid prescribing practices. Low prescription rates may indicate undertreatment, while high rates may indicate overprescribing and insufficient attention to risks of misuse.
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