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Four WNY counties among top opioid prescribers in state

The rate of opioid painkillers prescribed in Western New York is high compared to many other regions in the rest of the state, a new analysis shows.

Four counties here – Erie, Niagara, Chautauqua and Cattaraugus – landed among the top 10 with the highest opioid prescribing rates in 2015, according to the New York State Health Foundation. The "data snapshot" focused on state trends from statistics released earlier this year by the federal Centers for Disease Control and Prevention.

The good news? CDC data shows that, although opioid prescribing is high here compared to other counties in the state, it has decreased significantly since 2010, when the amount of opioids prescribed peaked in the United States. In Erie County, for instance, the amount of opioids prescribed has declined by 18 percent in that period, and in Niagara County by 22 percent.

"Our county has gone through a significant shift, especially with several large pain clinics that are no longer in operation," said Dr. Gale Burstein, Erie County health commissioner. "The prescribing practices here are changing with fewer offices that prescribe narcotics."

While opioid prescribing patterns vary widely across the state, the foundation found that counties with higher opioid prescription rates were clustered in the Western and Hudson Valley regions.

It also found that counties with higher rates tend to have smaller and older populations, a smaller proportion of racial and ethnic minorities, and higher rates of hospital use.

The foundation found a more than 400 percent difference in the rate of opioid prescribing from Sullivan County, which had the highest rate, to the the lowest, Kings County.

The counties with the highest rate of prescribing were:

Sullivan         1182.4

Chemung      1165.1

Warren          1005.3

Niagara           999.9

Chautauqua   940.4

Ulster              931.7

Greene            909.4

Erie                  885.3

Cattaraugus    871.8

Broome            862.2

The numbers describe the amount of opioids in morphine milligram equivalents per person in each county, a standardized figure that accounts for differences among opioid painkiller types and strength.

The counties with the lowest amount of prescribing in 2015 were:

Chenango            447.8

Albany                 439.9

Rockland             434.8

Yates                   418.9

Jefferson           409.4

Bronx                389.4

Lewis                366.6

Westchester     364.2

Queens             297.7

Kings               271.5

There is another sign that opioid prescribing is on the decline in the Buffalo Niagara region.

Hydrocodone-acetaminophen – a powerful, narcotic painkiller combined with Tylenol – was the most prescribed medication for Medicaid patients in Erie County for nearly a decade, but in 2016 it dropped to third place, The News reported in October.

This year, the drug’s ranking has dropped further to fifth place. The anti-inflammatory painkiller ibuprofen now holds the top spot. While ibuprofen is available over the counter, it requires a prescription in higher doses.

Statewide, the foundation reported that 17 counties saw an increase in opioid prescribing of 10 percent or more between 2010 and 2015, and 23 counties saw a decrease of more than 10 percent.

Demographics, urban or rural locations, income levels, and educational initiatives don't explain all the differences. Changing prescribing habits among physicians, as well as the availability of doctors who specialize in pain treatment, also play a role.

The CDC statistics showed that the United States has experienced a decrease in the amount of opioids prescribed, but use of the drugs remains high, with significant variations from one county to another across the country. The amount of opioids prescribed nationwide declined 18 percent from 2010 to 2015, although it increased in 23 percent of counties.

The county with the highest prescribing rate was Martinsville, Va., population 13,645, where there were 4,087 morphine milligram equivalents prescribed per person. The national average was 640.

The prescribing data is based on a sample of retail pharmacies in the U.S.

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