About the Report
The opioid epidemic has captivated the country for a decade, although it lost attention this year in the face of the COVID-19 pandemic, which affected the life and healthcare of patients with chronic pain and addiction and so many others. The impact of COVID-19 on use of prescription opioids has been modest, with use largely rebounding to baseline levels since June. Still, another year of double-digit declines in prescription opioid use in 2020 is expected to further reduce use in the United States to levels not seen since the early 2000s. While the human toll of the opioid epidemic is being addressed differently across the country, efforts in managing prescription opioids and in supporting medication-assisted treatment are showing measurable progress in many states.
Report Summary
This report provides a timely view of levels of, and trends in, opioid prescribing, how those vary by state, and how those variations illustrate progress and remaining risks. Prescription opioid volume is expected to drop for the ninth consecutive year — a decline of 60% from its peak in 2011. Per capita use of prescription opioids is expected to drop back to levels of use seen in the early 2000, with the greatest reductions in prescription opioid use – as measured in morphine milligram equivalents (MME) – seen in higher-risk segments taking more than 90 MMEs (per day. The greatest declines in prescription opioid use are seen in states which previously had the highest per capita use.
There has been further progress in reducing the highest-risk prescriptions and co-prescribing of opioids with anxiety drugs called benzodiazepines, which are linked to a higher risk of overdose and death. However, the decline in use of co-prescribed opioids and benzodiazepines has been lesser in patients over 65 than in younger patients. While combined prescribing of opioids and benzodiazepines is down by 30% since 2016, the number of seniors estimated to be receiving a combination regimen remains substantial at 1.2 million seniors.
There are sometimes no other alternatives to opioids for pain management, and current drugs for opioid use disorders are themselves narcotics, driving an intense research effort for alternatives, with only limited progress emerging. Treating underlying diseases with symptomatic pain and developing non-opioid therapies is the focus of the current pipeline. Unmet needs in addiction additionally are being addressed with ongoing research on new mechanisms of action and digital therapeutics.