HealthDay News — Clinicians in Alabama, the state with the highest number of opioid painkiller prescriptions, issued nearly three times as many of those prescriptions compared with practitioners in Hawaii, the lowest prescribing state, according to an analysis from the CDC.

Overall, health care providers wrote 259 million prescriptions for opioids in 2012, enough for every American adult to have a bottle of pills, said the CDC in their analysis.

Further analysis into opiate prescribing trends also found that 10 of the highest prescribing states for the medications are in the South, with Alabama, Tennessee, and West Virginia leading the nation. The Northeast, especially Maine and New Hampshire, had the most prescriptions per person for long-acting/extended-release painkillers and for high-dose painkillers.

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The CDC offered recommendations for clinicians for more effective opioid prescribing practices:

  • Use prescription drug monitoring programs to identify patients who might be misusing their prescription drugs, putting them at risk for overdose
  • Use effective treatments such as methadone or buprenorphine for patients with substance abuse problems
  • Discuss with patients the risks and benefits of pain treatment options, including ones that do not involve prescription painkillers
  • Follow best practices for responsible painkiller prescribing, including:
    • Screening for substance abuse and mental health problems
    • Avoiding combinations of prescription painkillers and sedatives unless there is a specific medical indication
    • Prescribing the lowest effective dose and only the quantity needed depending on the expected length of pain

The CDC analysis also found that states that crack down on narcotic painkiller prescriptions can dramatically limit the number of overdose deaths, crediting states and health care providers with the positive change.

“Data suggest that where health care providers practice influences how they prescribe. Higher prescribing of painkillers is associated with more overdose deaths. More can be done at every level to prevent overprescribing while ensuring patients’ access to safe, effective pain treatment,” wrote the CDC.