Shifting of opioid prescription rate reporting impacts both rural and urban counties

Abstract

Background: CDC annual reporting of opioid prescriptions per capita are key data used by systems for tracking opioid utilization and deaths. These data go back to 2006 and are measured at county-level resolution. Researchers and policy makers regularly use these data as inputs to models for tracking opioid trends geographically.

Methods: Recent changes in reporting of these data from the dispenser to provider cause a longitudinal break in the ability for data users to evaluate data points pre and post-change. This report examines the geographical impact of the data change in the context of both rural and urban counties. Data were segmented by county and tied to corresponding USDA rural-urban continuum codes for comparison.

Results: Opioid prescription data provides a distinct view into the opioid epidemic that allows all states and counties to view the trends of opioid utilization within their areas compared to themselves longitudinally as well as others. The reporting format change causes a break in the ability for communities to connect data before and after the change, especially in rural counties.

Conclusion: Researchers and policy makers need to be aware of the changes in opioid reporting metrics to avoid drawing false conclusions. In most cases, data before 2019 cannot be compared to later data points. The policy change in reporting significantly alters the ability to longitudinally analyze and connect information when examining county-level data. State-level trends are not impacted by this reporting change.

Keywords: Change; Opioid; Policy; Prescription; Reporting.