5 6 By Brenda L. Mooney ATLANTA—The national Centers for Disease Control and Prevention recently reported that the overall national opioid dispensing rate declined steadily from a rate of 46.8 opioid prescriptions dispensed per 100 persons in 2019 to a rate of 35.4 opioid prescriptions dispensed per 100 persons in 2024. For the report, opioid prescriptions included buprenorphine formulations commonly prescribed for treating pain (Belbuca and Butrans), codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, propoxyphene, tapentadol and tramadol. The declines weren’t equal across the nation, however. In some Deep South states—Louisiana, Mississippi, Alabama, Tennessee, Kentucky, as well as Arkansas and Oklahoma—average opioid prescriptions dispensed per 100 persons remained greater than 49.9. In many ways, the decline in opioid prescriptions has been even more dramatic at the VA, where it plum- meted by 67% from 2012 to 2023, primarily because of the agency’s Opioid Safety Initiative (OSI). The VA announced that 288,820 veterans had opioid prescrip- tions in 2023, compared to 874,897 in 2012. In the Military Health System, meanwhile, opioid prescribing dropped by more than 49% between 2016 and 2021, with high-dose prescriptions for active- duty members falling by 69%. The steep decline was attributed to stricter prescribing policies, such as the Stepped Care Model and the Opioid Overdose Education programs. Despite some good news, a study published last year in Translational Behavior Medicine pointed out that the opioid epidemic is an ongoing public health emergency and that rates of prescription opioid use, misuse and opioid-use disorder continue to increase in older adults 65 and older.1 “One of the major challenges to reducing prescription opioid use/misuse among older adults is that alternative pain management approaches are often not accessible,” explained the researchers led by Massachusetts General Hospital and Harvard Medical School. Congress took action, passing the Non-Opioids Opioid Epidemic Improved But Not Resolved in Federal Medicine, Elsewhere New Nonopioid Products Offer Some Viable Alternatives Even more change might be afoot with opioid prescribing at the VA. Congress has taken a strong position against over- prescribing of opioid painkillers by altering Medicare rules and now is considering something similar for the VHA. The recent FDA approval of the first nonopioid analgesic in more than two decades, meanwhile, adds to the options for replacing the addictive painkillers.
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