Trend in Opioid Analgesic Prescriptions and High-Risk Prescribing in the State of Illinois: An Eight-Year Descriptive...

Given the significant opioid epidemic in the United States, we investigated opioid-analgesic prescription trends and high-risk prescriptions in Illinois between 2015-2022.

Data from the Illinois Prescription Monitoring Program were analyzed for opioid prescription rates and high-risk prescriptions (i.e., multiple-prescribing providers, concurrent benzodiazepine, ≥ 90MME dose). Demographics (sex, age, and rural/urban classification using the Illinois Primary Health Care Association-2020) of high-risk prescriptions between 2018-2020 were analyzed using chi-square tests.

N = 45,522,885 opioid prescriptions were dispensed in Illinois between 2015-2022, declining by 47.1% (from 140.5 rate in 2015 to 74.4 in 2022). High-risk prescriptions comprise 12.6% of all prescriptions and decreased by 16.6% (from 16.9% in 2015 to 14.1% in 2022). Between 2018-2020, males received more high-risk prescriptions than females, although both males and females showed a reduction in ≥ 90MME prescriptions (19.5% vs. 15.9%, p < 0.0001) and multiple-provider prescriptions (36.1% vs. 27.3%, p < 0.0001). Individuals aged 56-70 received the highest high-risk prescriptions, while reductions in ≥ 90MME prescriptions occurred across all age groups. High-risk prescriptions were disproportionally dispensed in rural areas (67.8%), where reductions were greater in ≥ 90MME prescriptions (16.7% rural vs. 6.4% urban) and multiple-provider prescriptions (9.0% rural vs. 7.9% urban).

Despite declines in opioid-analgesic prescriptions in Illinois from 2015 to 2022, high-risk prescribing persists, particularly in rural areas and among specific demographic groups. Targeted, region-specific interventions and continued regulatory oversights are necessary to address geographic and population-level disparities in high-risk opioid prescribing.