Opioid and Stimulant Coprescriptions among South Carolina Residents

The South Carolina Department of Public Health (SCDPH) Prescription Drug Monitoring Program (PDMP) is used to monitor the prescribing patterns of controlled substances, including opioids and stimulants. Data collected by the National Center for Health Statistics show that the number of drug overdose deaths involving opioids and stimulants has been increasing since 1999. Although databases such as the PDMP monitor healthcare professionals' prescribing habits regarding opioids and stimulants individually, there has been little research regarding opioid-stimulant coprescribing patterns. Considering increasing death rates and the lack of research, data from the SCDPH PDMP were used to identify factors that influence opioid-stimulant coprescribing. It was hypothesized that younger age, higher daily morphine milligram milliequivalents (MMEs), increased duration of prescription, and male gender would be associated with increased opioid-stimulant coprescriptions.

Data were gathered from the SCDPH PDMP from 2016 to 2021. The variables assessed included patient age, patient sex, filling date, supply length, daily MMEs, and Lexicomp Drug Classification. A linear regression statistical analysis was then performed to analyze the data.

Between January 1, 2016 and December 31, 2021, a total of 9,785,146 opioid prescriptions were filled by 2,158,564 individuals, with 161,103 (1.65%) of them receiving a concurrent stimulant prescription. Patients who were 50 years of age and younger had a 2.74 greater odds of receiving a concurrent stimulant prescription (P<0.001), along with those who had an opioid prescription length of ≥ 30 days (odds ratio [OR] 4.38, P<0.001). Being female (OR 1.58) and a daily MME ≥ 50 mg but ≤100 mg (OR 1.24) were both significantly found to indicate an increased odds of having a concurrent prescription.

This study indicates that those with longer opioid prescriptions, younger individuals, higher daily MMEs, and women are at an increased risk of opioid-stimulant coprescription. Future research should investigate other factors associated with opioid-stimulant coprescribing, such as education status, rurality, and whether specific opioid or stimulant agents are linked to coprescribing.