State Of The Painkiller Nation: Wide Variation In Prescription Rates

VPM | By Scott Hensley

Published July 1, 2014 at 6:53 PM EDT

Updated December 11, 2023

There’s no getting around the fact that the abuse of prescription painkillers is a huge problem in the U.S. Prescription drug overdoses now kill more people each year than car crashes.

But the overdose risks vary quite a bit depending on where in the country you live. One reason is that how often doctors prescribed the drugs, such as Percocet, Vicodin and generic opioids, varies widely by state.

The Centers for Disease Control and Prevention analyzed a commercial database of drug prescriptions looking for patterns. Nationwide, there were 82.5 prescriptions written for opioid painkillers for every 100 Americans in 2012.

But the rates were much higher in some southern states. In Alabama, which led the country, there were 143 painkiller prescriptions for every 100 people in 2012. There were 11 other states where each adult, on average, got a least one painkiller prescription that year, including Tennessee, West Virginia and Kentucky.

CDC Director Dr. Thomas Frieden told reporters that officials don’t think the high rates of prescribing in some states are because people living there have more pain. “This is an epidemic that was largely caused by improper prescribing practices,” he said during a media briefing.

Prescription opioid drugs can be an important tool for helping patients in pain, he said, “but they’re not the answer every time someone has pain.”

The findings were published online in CDC’s Morbidity and Mortality Weekly Report.

Policy changes in some states can reduce problematic prescribing. State-run databases that monitor prescriptions and alert doctors can be useful. In Florida, regulations targeting pain clinics helped contribute to a decline in overdose deaths. So, too, did restrictions on doctors dispensing the drugs to patients from their offices.

Between 2010 and 2012, annual overdose deaths in Florida dropped 16.7 percent, from 3,201 to 2,666. And deaths from oxycodone, the generic name of the ingredient in many brand-name opioid painkillers, fell by more than half, according to an analysis published in MMWR.

“Florida,” Frieden said, “shows that policy and enforcement matter.”

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Scott Hensley

Scott Hensley edits stories about health, biomedical research and pharmaceuticals for NPR's Science desk. During the COVID-19 pandemic, he has led the desk's reporting on the development of vaccines against the coronavirus.

Hensley has worked on award-winning investigations in collaboration with journalistic partners.

He was the lead NPR editor on an investigation with the Center for Public Integrity in 2018 that exposed drug industry influence on the choices of preferred medicines by Medicaid programs. The work won the 2019 Gerald Loeb Award for audio reporting.

In 2017, Hensley was the lead NPR editor on an investigation with Kaiser Health News that showed how the pharmaceutical industry exploits government incentives intended to encourage the development of treatments for rare diseases. The stories won the 2019 digital award from the National Institute for Health Care Management.

Hensley has been editing in his current role since 2019. He joined NPR in 2009 to launch Shots, a blog that expanded to become a digital destination for NPR health coverage.

Before NPR, Hensley was a reporter and editor at The Wall Street Journal. He was the founding editor of The Wall Street Journal Health Blog, which focused on the intersection of health and business. As a reporter, he covered the drug industry and the Human Genome Project.

Hensley served on the board of the Association of Health Care Journalists from 2012 to 2020.

He has a bachelor's degree in natural sciences from Johns Hopkins University and a master's in journalism from Columbia University.

Before becoming a journalist, Hensley worked in the medical device industry. He remains, now and forever, a lover of Dobermans, lacrosse and Callinectes sapidus.

See stories by Scott Hensley