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A new report from the Center for Improving Value in Health Care (CIVHC), based on data in the Colorado All Payer Claims Database (CO APCD), helps isolate opportunities to reduce opioid use disorders in the state. While some common opioids are being filled less, the number of days supply being prescribed is often outside recommended guidelines, increasing the potential for addiction.
One critical approach to the multiple ways to address the opioid epidemic is to minimize the number of pills given to people with temporary, acute pain. Centers for Disease Control (CDC) research indicates that prescribing a longer duration dosage can significantly increase a person’s chance of becoming addicted. Therefore, the CDC suggests that providers offer alternative treatment options to opioids, and when necessary, prescribe the lowest effective dose for the shortest duration, typically three to seven days.
CO APCD data from 2009-2017 for short-acting versions of three commonly prescribed opioids – Oxycodone, Percocet, and Vicodin – indicates that prescribing often falls outside of CDC minimum necessary recommendations. More than half of all prescriptions for the three medications were for eight days or more and therefore outside of the CDC recommended guidelines. Oxycodone had higher rates of 15-30 days supply compared to 1-7 or 8-14 days, and 69 percent of all Oxycodone fills were for eight days or more.
According to the analysis, both Percocet and Vicodin fill rates have fallen since 2014, yet overall since 2009, Percocet fill rates have increased nearly 36 percent. In spite of being the least prescribed medication of the three in 2017, Oxycodone fill rates have more than tripled since 2009.
Colorado has been exploring solutions through a number of avenues including proposing legislation for treatment and recovery, Medicaid restrictions for opioid prescribing, the Colorado Hospital Association’s Colorado Opioid Safety Pilot and recommendations and education from the Colorado Consortium for Prescription Drug Abuse Prevention.