Opioid prescribing in the tri-county region

Updated June, 2019

  • The general trend of the number of individuals receiving non-tramadol opioids has declined from 2011 to 2018 across all counties.
  • The number of individuals receiving any opioid prescriptions >90 MED has declined from 2014.
  • The percentage of top prescribers using the PDMP data system has increased in all three counties from  about 10% to between 50% and 60%.
  • Clackamas County generally has the highest rates of individuals receiving non-tramadol opioids and prescription fills >90 MED; both rates are also slightly above the statewide rates.
  • Washington County generally has the lowest rates of individuals receiving non-tramadol opioids and prescription fills >90 MED.
     

Prescription opioids can be used appropriately for pain, misused by the intended patient, misused by others, or diverted for illegal sale. Excessive prescribing is likely to be an important driver of the opioid epidemic in Oregon and nationally. Responses include the Guideline for Prescribing Opioids for Chronic Pain, developed by the Centers for Disease Control and Prevention (CDC), and the promotion of state prescription drug monitoring programs (PDMPs).

The Oregon PDMP is a data system containing information on controlled-substance prescription medications dispensed by Oregon-licensed retail pharmacies. Oregon law requires pharmacies to submit data for all Schedule II–IV controlled substances dispensed, which include opioids, benzodiazepines, sedative hypnotics, stimulants, and other drugs. Oregon PDMP data is accessible to the public through interactive dashboards published on the Oregon Health Authority website.

The Oregon PDMP data below show the number of individuals receiving an opioid prescription per 1,000 residents each quarter. In order to view trends over time, tramadol prescriptions were not included because they were not reportable prior to mid-2014. Rates are presented by county, alongside the Oregon statewide prescribing rate.

Graph showing Individuals Receiving Opioids (non-tramadol) per 1,000 residents

 

Prescriptions totaling more than 90 morphine equivalent doses (MED) per day increase the risk of opioid-related harms and are an indicator of risky prescribing practices. The data below show rates of high dose prescribing and are calculated based on the total number of people who exceed the >90 MED threshold in a quarter.

Graph showing >90 MED Individuals per 1,000 residents from any fill

 

The 4,000 prescribers with the highest number of controlled substance prescriptions filled by patients in the state are identified each quarter. The chart below shows the percentage of these prescribers in the Tri-County region that utilized the PDMP system during that quarter. Statewide data are not available from the PDMP system at time of reporting.

Graph showing percent of top prescribers querying PDMP

 

The data in this brief are prescription data from the Oregon PDMP which collects all schedule II, III, and IV outpatient retail pharmacy fills dispensed in Oregon or to Oregonians. PDMP data come from published and unpublished Oregon Health Authority datasets. Data gets updated as soon as it is available, generally quarterly with a one-month delay.

Denominator: Rate measures are calculated using county population as denominators. For graphs 1 and 2, the denominators are the general county population. For Graph 3, the denominator is the 4,000 prescribers with the highest number of prescriptions of controlled substances filled at pharmacies in the state.

Numerators: For Graph 1, the numerator is the number of individuals receiving an opioid prescription, not including tramadol. For Graph 2, the numerator is the number of individuals receiving a prescription stronger than 90 MED. For Graph 3, the numerator is the number of the 4,000 prescribers with the highest number of prescriptions of controlled substances in the state who have used the PDMP data system during the respective quarter.

Limitations: These data only represent prescription opioid patterns in Oregon and cannot be used to extrapolate information on illicit drugs such as heroin, fentanyl, or carfentanyl, nor do they reflect the prevalence of diversion of prescription drugs within the state, between states, and across borders. These data also do not provide information about how many prescription opioids are being misused, abused, or diverted. They also do not show how many people receiving these prescriptions have or develop a substance use disorder.