1. All about the Data: Opioid Prescribing Trends and Other Opioid Outcome Metrics for Arkansas

2. Data Sources ADH: Other AR Data: National: Vital Statistics PDMP
ED and Hospital Discharge
EMS
Other AR Data:
Crime Lab
National:
CDC Wonder
Medicare Part D
CDC National Center for Health Statistics
National Inpatient Sample

3. CDC Prescribing Rate is based on a sample of approximately 50,000 retail (non-hospital) pharmacies, which dispense nearly 90% of all retail prescriptions in the United States. For this database, a prescription is an initial or refill prescription dispensed at a retail pharmacy in the sample and paid for by commercial insurance, Medicaid, Medicare, or cash number should be available in late summer of 2019.
*Does not include buprenorphine products

4. *Raw Data from AR PDMP

10. Total Morphine Milligram Equivalents Dispensed
Total Morphine Milligram Equivalents Dispensed* in Arkansas for a Specific Year
*Note: Filled by AR residents
Source: Arkansas Prescription Drug Monitoring Program

11. *Note: Filled by AR residents

12. Top-Selling* Prescription Drugs by Class in Arkansas in 2018
Rank
Drug Type
Pills Sold
Number of prescriptions 1
Opioid
186,424,459
3,283,428 2
Benzo
86,029,755
1,739,022 3
Stimulant
26,846,338
762,057 4
Zolpidem
14,236,720
499,592 5
Muscle Relaxant
5,869,053
93,071
Total
319,406,325
6,377,170
*Note: Filled by AR residents
Source: Arkansas Prescription Drug Monitoring Program

13. Neonatal Abstinence Syndrome

14. Incidence of NAS by primary payer.
Data Source: 2004–2014 hospital birth data from the National Inpatient Sample, a nationally representative sample of hospital discharges in the United States (N = 13 102 793)
Incidence of NAS by primary payer.
Tyler N.A. Winkelman et al. Pediatrics 2018;141:e
©2018 by American Academy of Pediatrics

15. NAS by County

16. NAS Demographics

17. Opioid Prescribing to Women of Reproductive Age
*Raw Data from AR PDMP

18. Drug Overdose Death Rate vs Motor Vehicle-Related Death Rate for AR

19. Age-Adjusted Drug Overdose Death Rate

20. Drug Overdose Death Rate by Demographics
Source: ADH Vital Statistics

21. Rate per 100,000 people of naloxone administrations by Emergency Medical Services (EMS) personnel by county 2017 and 2018
*Note: These data include all instances naloxone was administered by EMS personnel. Naloxone may have been administered for non-opioid overdoses.
SOURCE: Arkansas Department of Health Emergency Medical Services and Trauma Branch

22. Drugs Involved in Fatal Overdoses among AR Residents in 2016
Source: ADH Vital Statistics

23. Non-Fatal Heroin Overdose Rate from ED hospital discharge data using ICD9/ICD10 Codes
Source: ADH and National Statistics System Mortality File

24. Non-Fatal Heroin Overdose Rate by Demographics

25. Homicides vs. Drug Overdoses
MEDICAL EXAMINER
Autopsies Conducted 2014 – 2018
Homicides vs. Drug Overdoses
Homicides
Drug Overdoses

26. MEDICAL EXAMINER Autopsies Conducted 2014 – 2018 Drug Overdose Trends
Heroin
Fentanyl
Methamphetamine

28. Antibiotic and Opioid Prescription Patterns

29. Takeaway Points
The number of opioid prescriptions issued monthly from AR prescribers to AR patients is on the decline, going from roughly a little over 250,000 opioid prescriptions per month in 2014 to close to 220,000 opioid prescriptions per month in the later portions of That is a 12% decrease of opioid prescriptions in 4 years.
The average number of opioid prescriptions per AR prescriber has decreased from about 50 per month to closer to 40 in the end of 2018.
The number of days’ supply of opioids per prescription is high and climbing slightly, going from around 17 days’ supply per prescription to over 18 days’ supply per prescription in 2018.
The number of Arkansans on chronic opioid therapy in any given 6 month period is between 120,000 to 130,000 and is relatively stable in numbers. However, even at its lowest, that number shows that almost 4% of Arkansans are on chronic opioids in any given 6 month period.
NAS is on the rise, being documented more systematically, or both.
Uptake in administration of naloxone has been extensive.
Overdoses are on the rise, particularly for heroin and likely fentanyl.

30. Case Conference and Feedback
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