Eight-Year Trend in Opioid-Analgesic Prescriptions and High-Risk Prescriptions in Illinois.

Objectives: Given the pressing public health crisis due to the opioid epidemic in United States, this retrospective analysis aimed to investigate the trends in opioid-analgesic prescriptions and high-risk prescriptions in the State of Illinois between 2015-2022, and analyze demographic patterns between 2018-2020.
Methods: Illinois Prescription Monitoring Program was searched for rates of opioid-analgesic prescription and high-risk prescriptions (i.e., multiple-prescribing providers, concurrent benzodiazepine, prescription dosing >90MME). Data on high-risk opioid-analgesic prescriptions between 2018-2020 were analyzed with chi-square by sex, age, and rural/urban classification (Illinois Primary Health Care Association, 2020).
Results: N=45,522,885 opioid prescriptions were dispensed in Illinois between 2015-2022, with a 47.1% decline (from 140.5 rate in 2015 to 74.4 rate in 2022). High-risk prescriptions accounted for 12.6% of all prescriptions, with a 16.6% drop (from 16.9% in 2015 to 14.1% in 2022). Between 2018-2020, males received more high-risk prescriptions than females (346,815 vs 316,467, p<.001). However, both males and females exhibited steady reduction in >90MME prescriptions over time (by 19.5% and 15.9% respectively, p<.0001) and in multiple-provider prescriptions (by 36.1% and 27.3% respectively, p<.0001). Between 2018-2020, individuals between 56-70 years received the highest high-risk prescriptions across the study-period. Individuals <24 and between 41-55 years exhibited a reduction in multiple-provider prescriptions (p<.0001). All age groups, except for individuals between 56-70 years, exhibited a reduction in >90MME prescriptions (p<.0001). Between 2018-2020, 67.8% of >90MME high-risk prescriptions were dispensed to rural areas, which exhibited higher average rates across all study-period. Nevertheless, >90MME prescriptions decreased by 16.7% in rural and 6.4%in urban areas (p<.0001), while multiple-provider prescriptions decreased by 9.0% in rural and 7.9% in urban areas.
Conclusions: Illinois has seen a decline in opioid-analgesic prescriptions over the last decade. However, high-risk prescriptions remain high in rural areas providing opportunity to tailor interventions in these particular regions to reduce geographic disparities