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Rates of opioid use in the United States do not appear to be declining

U.S. Opioid Use Not Declining, Despite Focus on Abuse

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Higher average daily dose seen in 2017 versus 2007, particularly for the disabled
There was an increase in buprenorphine with naloxone fills in expansion versus nonexpansion counties after Medicaid expansion

Buprenorphine/Naloxone Rx Fills Up With Medicaid Expansion

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Significant increase in buprenorphine with naloxone fills per 100,000 county residents in expansion areas
Four more online networks that operate 21 websites illegally selling potentially dangerous

FDA Warning Letters Target Illegal Online Sales of Opioids

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Medications may be counterfeit, contaminated, expired, or otherwise unsafe
Implementation of a mandatory prescription drug monitoring program does not necessarily reduce the overall rate of opioid prescribing or the mean number of pills prescribed for patients undergoing general surgical procedures

Prescription Drug Monitoring Program May Not Cut Opioid Use

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No significant reduction in percentage of patients prescribed opioids after general surgery
Release of the U.S. Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain in March 2016 corresponded to greater increases in several opioid prescribing patterns

Bigger Drop in Opioid Prescribing After CDC Guideline Release

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Several opioid prescribing practices were decreasing before guideline; release linked to greater declines
Hydrocodone's change from schedule III to schedule II in 2014 was associated with an increase in the amount of opioids filled in the initial prescription after surgery

Hydrocodone Schedule Change Affected Post-Op Opioid Rx

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Increase in mean OMEs filled in initial opioid rx after hydrocodone's change from schedule III to II
The American Medical Association encourages patient education to raise awareness of the risks associated with opioid use after a prolonged period of sobriety

Patient Education Urged to Prevent Opioid OD After Sobriety

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Airlines also encouraged to include naloxone in emergency medical kits
Concomitant exposure to pregabalin and opioids is associated with increased odds of opioid-related death

Odds of Death Up With Exposure to Pregabalin, Opioids

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Dose-response association with highest odds of opioid-related death with high-dose pregabalin
Significant improvements in neonatal abstinence syndrome outcomes can result from a comprehensive quality improvement program

QI Program Can Up Outcomes for Neonatal Abstinence Syndrome

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Decreases in pharmacologic treatment, adjunctive agent use, hospital length of stay, opioid tx days
Opioid dependence is more likely to occur in patients with degenerative spondylolisthesis before surgery than afterward

Opioid Dependence More Common Before Spine Surgery

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Findings based on large study of patients having surgery for degenerative spondylolisthesis