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Many patients who develop new low back pain receive advanced imaging and opioids without having been prescribed nonsteroidal anti-inflammatory drugs or physical therapy

Many Patients Receive Guideline-Nonconcordant Care for Low Back Pain

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One-third of patients received opioids, more than half of whom had not received prescription NSAIDs, PT
A small proportion of providers account for almost half of all opioid doses and about one-quarter of opioid prescriptions

Just a Few Providers Account for Large Number of Opioid Scripts

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Top 1 percent of providers account for 49 percent of all opioid doses, 27 percent of all opioid prescriptions
Naloxone prescribing has increased but is still very low among patients at risk for opioid overdose

Naloxone Prescribing Increasing but Still Very Low

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Factors associated with naloxone fills include high opioid daily dosage, concurrent benzodiazepines
Medicaid expansion is associated with a reduction in total opioid overdose deaths and with increases in methadone-related mortality

Total Opioid Overdose Deaths Down With Medicaid Expansion

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But increase observed in methadone-related overdose mortality in Medicaid expansion states
The percentage of emergency department visits with an opioid prescribed increased from 2006-2007 to 2010-2011 then decreased to 2016-2017

Recent Years Saw Drop in Opioid Prescribing at ED Discharge

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Opioid prescribing at discharge increased from 2006-2007 to 2010-2011 followed by drop in 2016-2017
Data from the U.S. Centers for Disease Control and Prevention may be underreporting overdose deaths caused by opioids and other drugs

CDC Data May Be Underreporting Scope of Overdose Deaths

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Number of deaths in Florida 19 to 39 percent higher using Florida Medical Examiners Commission data
From 2007 to 2017

Prevalence of Buprenorphine-Waivered Prescribers Increasing

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Increase seen from 2007 to 2017; growth faster in counties with higher rates of opioid-related OD deaths
Less than one-third of youths surviving an opioid overdose receive timely addiction treatment

Few Youths Receive Addiction Treatment After Opioid Overdose

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Only 1.9 percent of Medicaid-enrolled youth received pharmacotherapy after nonfatal opioid overdose
Adolescents who report misusing prescription opioids are more likely to have engaged in a range of other risky behaviors

Teens Who Misuse Opioids Likely to Engage in Other Risky Behaviors

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Likelihood increased for engaging in 22 risky behaviors for those who misuse prescription opioids
From 2014 to 2016

2014 to 2016 Saw Decline in U.S. Adults Prescribed Opioids

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Decrease larger for U.S. adults reporting moderate or more severe pain versus less-than-moderate pain