Epidemiology of Controlled Substance Prescription Drug Utilization in Texas: an Analysis of Prescription Drug Monitoring Program Data
Ferries, Erin A
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Background: Prescription drug abuse has reached epidemic levels, leading to dire health outcomes and economic implications. Both patient-level and environmental-level factors are believed to contribute to higher rates of prescription drug abuse. While national estimates of abuse have been extensively studied, this phenomenon has not been examined in the State of Texas. The objective of this research was to determine the prevalence and factors associated with multiple provider episodes in Texas. Methods: This study was a retrospective, cohort analysis of data obtained from the Texas prescription drug monitoring database (PDMP) which was linked with Texas county-level census data. Descriptive statistics and multi-level model regression analysis were employed to determine the prevalence of multiple provider episodes (MPE) and analyze the association between patient-level, prescription utilization and county-level factors with MPEs. Results: Opioid prescriptions, especially hydrocodone-combination products (38.64%), were the most frequently utilized controlled substance prescriptions (CSPs) dispensed. The prevalence of MPEs was 185.16 per 100,000 population. Among those identified in the MPE cohort, 76.98% utilized CSPs >150 days and 11.48% had a daily morphine equivalent (MED) ≥100 mg/day. Residing in metropolitan areas, traveling >100 miles to obtain prescriptions, chronic use of CSPs, younger age, and high daily MED were all factors significantly associated with an increased risk of MPE. Conclusion: Prescription drug abuse has been identified as a major public health problem in Texas. Prescription drug abuse prevention efforts need to be addressed at both the patient-level and through legislation regarding public health and policy.