Prescription drug stats shared for Valley counties


VALLEY — Nationally and in Colorado, opioid use disorders have emerged as a significant public health concern.

Nearly 224,000 Coloradans misuse prescription drugs each year. In nearly every year for the last 15 years, Colorado’s drug overdose rate was significantly higher than the national rate and opioid related overdoses represent a large portion of those deaths. In Colorado, prescription opioid related overdoses have quadrupled since 2000.

San Luis Valley statistics have mirrored or in some cases exceeded state trends.

In 2014, Colorado legislators passed a bill allowing the Colorado Department of Public Health and Environment to access Prescription Drug Monitoring Program (PDMP) data to provide population-level results. In compliance with this legislation, reports have been released describing data on the prescribing and dispensing of controlled substances from the Colorado PDMP for Colorado residents.

These reports include information from San Luis Valley counties and describe dispensing data of controlled substances, with a focus on opioid prescriptions.

The Colorado PDMP is a secure database that collects information on schedule 2-5 controlled substances prescriptions dispensed by Colorado pharmacies.

Valley stats

The profiles below summarize controlled substance prescriptions that residents in San Luis Valley counties received from 2014-2016, prescribing practices and patient behaviors, population-level healthcare encounters and deaths related to opioid overdose. This information is from several sources: The Colorado Prescription Drug Monitoring Program, emergency department visit and hospital discharge databases and death certificates.

Alamosa County

In Alamosa County from 2014-2016, opioids represented a majority of prescriptions dispensed, followed by benzodiazepine prescriptions. The percentage of opioid prescriptions decreased in the three-year period.

In 2016, Alamosa County prescribers wrote 62 percent of the prescriptions dispensed to county residents and 83 percent of prescriptions were dispensed at pharmacies within the county. However, the county of residence may differ from the counties where the prescriptions were obtained. For instance, prescribers in the neighboring counties of Rio Grande and Conejos collectively wrote 14 percent of prescriptions dispensed to Alamosa County residents.

Characteristics of Controlled Substance Prescriptions Dispensed, Alamosa County,

2014-2016

Number of Prescriptions Dispensed: 17,941 in 2014; 20,960 in 2015; 20,535 in 2016

Number of Unique Patients: 3,912 in 2014; 3,994 in 2015; 3,929 in 2016

Opioid prescription rates peaked in 2015 and prescription rates for all drug classes increased in the three-year period. Compared to the state, Alamosa County had elevated opioid prescription rates.

High Risk Prescribing Practices and Patient Behaviors, 2014-2016

Percent of Alamosa County patients receiving more than 90 morphine milligram equivalents: 9.4% compared to 10.3% statewide in 2014; 10.0% compared to 8.9% statewide in 2015; 10.1% compared to 8.7% statewide in 2016

Percent of patients receiving more than 120 morphine milligram equivalents: 5.7% compared to 6.3% statewide in 2014; 6.1% compared to 5.5% statewide in 2015; 6.0% compared to 5.2% statewide in 2016

Rate of multiple provider episodes per 100,000 residents (receiving opioid prescriptions from five or more prescribers and pharmacies in a six-month period): 18.9 compared to 60.8 statewide in 2014; 6.3 compared to 43.1 statewide in 2015; 6.3 compared to 32.0 statewide in 2016

Percent of patients prescribed long duration opioids who were opioid-naïve (patients who did not fill an opioid prescription in the previous 60 days): 20.4% compared to 16.0% statewide in 2014; 18.7% compared to 15.3% statewide in 2015; 14.2% compared to 13.5% statewide in 2016

Percent of patient prescription days with overlapping opioid prescriptions: 20.0% compared to 22.3% statewide in 2014; 22.6% compared to 21.6% statewide in 2015; 21.2% compared to 21.2% statewide in 2016

Percent of patient prescriptions days with overlapping opioid and benzodiazepine prescriptions: 8.8% compared to 12.1% statewide in 2014; 12.3% compared to 11.9% statewide in 2015; 12.2% compared to 11.3% statewide in 2016

Opioid overdose related emergency department (ED) visits, hospitalizations and fatal overdoses have increased nationally and in Colorado over the last decade.

Emergency Department Visits Related to Prescription Opioid Overdose

From 2012-2014, Coloradans made 2,404 visits per year to Emergency Departments (ED) related to prescription opioid poisoning. In Alamosa County from 2012-2014, there were seven ED visits involving prescription opioids. Alamosa County had the 19th highest ED visit rate in the state placing it in the middle quintile range.

Hospitalization Data Related to Prescription Opioid Overdose

In 2013, 21 percent of the drug poisoning hospitalizations in Colorado were related to prescription opioid poisoning.

Alamosa County experienced three hospitalization visits related to prescription opioids in the three-year period. Excluding the 19 counties where data were suppressed, Alamosa County had the second lowest rate in the state.

Death Certificate Data Related to Prescription Opioid Overdose

In Colorado in 2015, 37 percent of all drug poisoning deaths involved prescription opioids. Opioid related poisoning deaths tripled from 1.9 in 2000 to 5.8 per 100,000 in 2015.

Alamosa County was one of 26 counties where data were available. Alamosa County had the ninth highest opioid-related death rate, placing it in the fourth quintile and higher than the state rate.

Conejos County

Opioids represented a majority of prescriptions dispensed, and benzodiazepines represented about a quarter of prescriptions dispensed to Conejos County residents during the 2014-2016 period.

In 2016, Conejos County prescribers wrote 43 percent of the prescriptions dispensed to county residents and 34 percent of prescriptions were dispensed within the county. However, the county of residence may differ from the counties where the prescriptions are obtained. For instance, prescribers in the neighboring counties of Alamosa wrote 31 percent of the prescriptions dispensed and pharmacies in Alamosa County filled 50 percent of prescriptions dispensed to Conejos County residents.

Characteristics of Controlled Substance Prescriptions Dispensed, Conejos County, Colorado, 2014-2016

Number of Prescriptions Dispensed: 10,523 in 2014; 11,463 in 2015; 10,249 in 2016

Number of Unique Patients: 1,909 in 2014; 1,837 in 2015; 1,704 in 2016

Opioid prescription rates in Conejos County generally mirrored state trends with prescription rates peaking in 2015.

Compared to the state, Conejos County had elevated opioid prescription rates during the three-year period.

High Risk Prescribing Practices and Patient Behaviors, 2014-2016

Percent of Conejos County patients receiving more than 90 morphine milligram equivalents: 9.8% compared to 10.3% statewide in 2014; 9.0% compared to 8.9% statewide in 2015; 8.85% compared to 8.7% statewide in 2016

Percent of patients receiving more than 120 morphine milligram equivalents: 6.8% compared to 6.3% statewide in 2014; 6.0% compared to 5.5% statewide in 2015; 6.0% compared to 5.2% statewide in 2016

Rate of multiple provider episodes per 100,000 residents (receiving opioid prescriptions from five or more prescribers and pharmacies in a six-month period): 6.1 compared to 60.8 statewide in 2014; 6.2 compared to 43.1 statewide in 2015; 12.4 compared to 32.0 statewide in 2016

Percent of patients prescribed long duration opioids who were opioid-naïve (patients who did not fill an opioid prescription in the previous 60 days): 15.4% compared to 16.0% statewide in 2014; 12.0% compared to 15.3% statewide in 2015; 11.0% compared to 13.5% statewide in 2016

Percent of patient prescription days with overlapping opioid prescriptions: 17.4% compared to 22.3% statewide in 2014; 19.2% compared to 21.6% statewide in 2015; 17.8% compared to 21.2% statewide in 2016

Percent of patient prescriptions days with overlapping opioid and benzodiazepine prescriptions: 13.5% compared to 12.1% statewide in 2014; 15.7% compared to 11.9% statewide in 2015; 14.7% compared to 11.3% statewide in 2016

Emergency Department Visits Related to Prescription Opioid Overdose

Conejos County was one of the 28 counties where data were suppressed due to small sample sizes.

Hospitalization Data Related to Prescription Opioid Overdose

Conejos County experienced six hospitalization visits related to prescription opioids in the three-year period. Excluding the 19 counties where data were suppressed,

Conejos County had the eighth highest rate in the state.

Death Certificate Data Related to Prescription Opioid Overdose

Conejos County was one of 38 counties where county level data were suppressed.

Costilla County

Opioids represented a majority of prescriptions dispensed, followed by benzodiazepine prescriptions. The percentage of sedative prescriptions decreased in the three-year period.

In 2016, Costilla County prescribers wrote 19 percent of the prescriptions dispensed to county residents and 11 percent of prescriptions were dispensed by pharmacies within the county. However, the county of residence may differ from the counties where the prescriptions were obtained. For instance, prescribers in the neighboring counties of Alamosa wrote 36 percent of the prescriptions and Conejos prescribers wrote 17 percent of the prescriptions dispensed to Costilla County residents. Additionally, pharmacies in Alamosa County dispensed 73 percent of prescriptions dispensed to Costilla County residents.

Characteristics of Controlled Substance Prescriptions Dispensed, Costilla County, 2014-2016

Number of Prescriptions Dispensed: 6,800 in 2014; 7,735 in 2015; 7,598 in 2016

Number of Unique Patients: 1,343 in 2014; 1,408 in 2015; 1,363 in 2016

Every year in Costilla County, there were enough opioid prescriptions for every resident to have at least one prescription. Compared to the state, Costilla County had elevated opioid and benzodiazepine prescription rates.

High Risk Prescribing Practices and Patient Behaviors, 2014-2016

Percent of Costilla County patients receiving more than 90 morphine milligram equivalents: 11.3% compared to 10.3% statewide in 2014; 10.8% compared to 8.9% statewide in 2015; 8.8% compared to 8.7% statewide in 2016

Percent of patients receiving more than 120 morphine milligram equivalents: 7.45% compared to 6.3% statewide in 2014; 7.2% compared to 5.5% statewide in 2015; 6.6% compared to 5.2% statewide in 2016

Rate of multiple provider episodes per 100,000 residents (receiving opioid prescriptions from five or more prescribers and pharmacies in a six-month period): 28.1 compared to 60.8 statewide in 2014; 55.9 compared to 43.1 statewide in 2015; 14 compared to 32.0 statewide in 2016

Percent of patients prescribed long duration opioids who were opioid-naïve (patients who did not fill an opioid prescription in the previous 60 days): 15.4% compared to 16.0% statewide in 2014; 12% compared to 15.3% statewide in 2015; 11% compared to 13.5% statewide in 2016

Percent of patient prescription days with overlapping opioid prescriptions: 17.4% compared to 22.3% statewide in 2014; 19.2% compared to 21.6% statewide in 2015; 17.8% compared to 21.2% statewide in 2016

Percent of patient prescriptions days with overlapping opioid and benzodiazepine prescriptions: 13.5% compared to 12.1% statewide in 2014; 15.7% compared to 11.9% statewide in 2015; 14.7% compared to 11.3% statewide in 2016

Emergency Department Visits, Hospitalization Data and Death Certificate Data Related to Prescription Opioid Overdose

Costilla County data were suppressed due to due to small sample sizes.

Mineral County

Opioids represented a majority of prescriptions dispensed, and benzodiazepines represented a quarter of prescriptions. The percentage of opioid and benzodiazepine prescriptions decreased in the three-year period.

In 2016, Mineral County prescribers wrote two percent of the prescriptions dispensed to county residents and no prescriptions were dispensed by pharmacies within the county. However, the county of residence may differ from the counties where the prescriptions are obtained. For instance, prescribers in the neighboring counties of Hinsdale wrote 33 percent of the prescriptions and Rio Grande prescribers wrote 26 percent of the prescriptions dispensed to Mineral County residents. Additionally, pharmacies in Rio Grande County filled 50 percent of prescriptions dispensed and pharmacies in Alamosa filled 22 percent of prescriptions dispensed to Mineral County residents.

Characteristics of Controlled Substance Prescriptions Dispensed, Mineral County, 2014-2016

Number of Prescriptions Dispensed: 1,159 in 2014; 1,481 in 2015; 1,167 in 2016

Number of Unique Patients: 263 in 2014; 255 in 2015; 211 in 2016

In Mineral County, opioid and benzodiazepine prescription rates peaked in 2015 and decreased in 2016. Compared to the state, Mineral County had elevated opioid and stimulant prescription rates.

High Risk Prescribing Practices and Patient Behaviors, 2014-2016

Percent of Mineral County patients receiving more than 90 morphine milligram equivalents: 4.3% compared to 10.3% statewide in 2014; 5.7% compared to 8.9% statewide in 2015; 8.3% compared to 8.7% statewide in 2016

Percent of patients receiving more than 120 morphine milligram equivalents: 3.2% compared to 6.3% statewide in 2014; 3.9% compared to 5.5% statewide in 2015; 5.7% compared to 5.2% statewide in 2016

Rate of multiple provider episodes per 100,000 residents (receiving opioid prescriptions from five or more prescribers and pharmacies in a six-month period): 0 compared to 60.8 statewide in 2014; 0 compared to 43.1 statewide in 2015; 137.4 compared to 32.0 statewide in 2016

Percent of patients prescribed long duration opioids who were opioid-naïve (patients who did not fill an opioid prescription in the previous 60 days): 43.3% compared to 16.0% statewide in 2014; 30.6% compared to 15.3% statewide in 2015; 21.4% compared to 13.5% statewide in 2016

Percent of patient prescription days with overlapping opioid prescriptions: 13.9% compared to 22.3% statewide in 2014; 15.1% compared to 21.6% statewide in 2015; 24% compared to 21.2% statewide in 2016

Percent of patient prescriptions days with overlapping opioid and benzodiazepine prescriptions: 14.2% compared to 12.1% statewide in 2014; 14.4% compared to 11.9% statewide in 2015; 13.4% compared to 11.3% statewide in 2016

Emergency Department Visits, Hospitalization Data and Death Certificate Data Related to Prescription Opioid Overdose

Mineral County was one of the counties where data were suppressed due to small sample sizes.

Rio Grande County

Opioids represented a majority of prescriptions dispensed, followed by benzodiazepine prescriptions.

In 2016, Rio Grande County prescribers wrote 51 percent of the prescriptions dispensed to county residents and 63 percent of prescriptions were dispensed within the county. However, the county of residence may differ from the counties where the prescriptions were obtained. For instance, prescribers in the neighboring county of Alamosa wrote 23 percent of the prescriptions dispensed and pharmacies in Alamosa County dispensed 24 percent of prescriptions dispensed to Rio Grande residents.

Characteristics of Controlled Substance Prescriptions Dispensed, Rio Grande County, 2014-2016

Number of Prescriptions Dispensed: 16,148 in 2014; 18,002 in 2015; 16,955 in 2016

Number of Unique Patients: 3,287 in 2014; 3,234 in 2015; 3,114 in 2016

In Rio Grande, opioid prescription rates peaked in 2015 but benzodiazepine and stimulant prescription rates remained stable during the three-year period. Compared to the state, Rio Grande County had elevated opioid prescription rates.

High Risk Prescribing Practices and Patient Behaviors, 2014-2016

Percent of Rio Grande County patients receiving more than 90 morphine milligram equivalents: 8.7% compared to 10.3% statewide in 2014; 8.9% compared to 8.9% statewide in 2015; 9.25% compared to 8.7% statewide in 2016

Percent of patients receiving more than 120 morphine milligram equivalents: 5.4% compared to 6.3% statewide in 2014; 5.7% compared to 5.5% statewide in 2015; 5.7% compared to 5.2% statewide in 2016

Rate of multiple provider episodes per 100,000 residents (receiving opioid prescriptions from five or more prescribers and pharmacies in a six-month period): 25.9 compared to 60.8 statewide in 2014; 26.1 compared to 43.1 statewide in 2015; 13.1 compared to 32.0 statewide in 2016

Percent of patients prescribed long duration opioids who were opioid-naïve (patients who did not fill an opioid prescription in the previous 60 days): 14.8% compared to 16.0% statewide in 2014; 11% compared to 15.3% statewide in 2015; 10% compared to 13.5% statewide in 2016

Percent of patient prescription days with overlapping opioid prescriptions: 18.1% compared to 22.3% statewide in 2014; 19.9% compared to 21.6% statewide in 2015; 19.9% compared to 21.2% statewide in 2016

Percent of patient prescriptions days with overlapping opioid and benzodiazepine prescriptions: 10.9% compared to 12.1% statewide in 2014; 10.2% compared to 11.9% statewide in 2015; 10.7% compared to 11.3% statewide in 2016

Emergency Department Visits Related to Prescription Opioid Overdose

In Rio Grande County from 2012-2014, there were four ED visits involving prescription opioids. Rio Grande County had one of the lower ED visit rates in the state, placing it in the second quintile range.

Hospitalization Data Related to Prescription Opioid Overdose

Rio Grande County experienced six hospitalization visits related to prescription opioids in the three-year period. Excluding the 19 counties where data were suppressed, Rio Grande County ranked 25th out of the 45 remaining counties.

Death Certificate Data Related to Prescription Opioid Overdose

Rio Grande County was one of 38 counties where data were suppressed due to small sample sizes.

Saguache County

Opioids represented a majority of prescriptions dispensed, followed by benzodiazepine prescriptions. There were only minor changes in the three-year period.

In 2016, Saguache County prescribers wrote 17 percent of the prescriptions dispensed to county residents and no prescriptions were dispensed within the county. The county of residence may differ from the counties where the prescriptions were obtained. For instance, prescribers in the neighboring counties of Alamosa wrote 28 percent of prescriptions, Chaffee prescribers wrote 18 percent, and Rio Grande prescribers wrote 11 percent of the prescriptions dispensed to Saguache County residents. Additionally, pharmacies in Alamosa dispensed 42 percent of prescriptions while pharmacies in Chaffee and Rio Grande County dispensed 24 and 21 percent, respectively.

Characteristics of Controlled Substance Prescriptions Dispensed, Saguache County, 2014-2016

Number of Prescriptions Dispensed: 7,631 in 2014; 8,296 in 2015; 7,995 in 2016

Number of Unique Patients: 1,589 in 2014; 1,602 in 2015; 1,606 in 2016

Opioid prescription rates in Saguache County mirrored state trends with rates peaking in 2015.

Compared to the state, Saguache County had elevated opioid prescription rates.

High Risk Prescribing Practices and Patient Behaviors, 2014-2016

Percent of Saguache County patients receiving more than 90 morphine milligram equivalents: 9.5% compared to 10.3% statewide in 2014; 9.1% compared to 8.9% statewide in 2015; 9.6% compared to 8.7% statewide in 2016

Percent of patients receiving more than 120 morphine milligram equivalents: 6.2% compared to 6.3% statewide in 2014; 6.1% compared to 5.5% statewide in 2015; 5.4% compared to 5.2% statewide in 2016

Rate of multiple provider episodes per 100,000 residents (receiving opioid prescriptions from five or more prescribers and pharmacies in a six-month period): 40.4 compared to 60.8 statewide in 2014; 47.9 compared to 43.1 statewide in 2015; 16 compared to 32.0 statewide in 2016

Percent of patients prescribed long duration opioids who were opioid-naïve (patients who did not fill an opioid prescription in the previous 60 days): 11.6% compared to 16.8% statewide in 2014; 30.6% compared to 15.3% statewide in 2015; 10.2% compared to 13.5% statewide in 2016

Percent of patient prescription days with overlapping opioid prescriptions: 23.6% compared to 22.3% statewide in 2014; 22.3% compared to 21.6% statewide in 2015; 22.3% compared to 21.2% statewide in 2016

Percent of patient prescriptions days with overlapping opioid and benzodiazepine prescriptions: 14.2% compared to 12.1% statewide in 2014; 14.2% compared to 11.9% statewide in 2015; 13.9% compared to 11.3% statewide in 2016

Emergency Department Visits Related to Prescription Opioid Overdose

In Saguache County from 2012-2014, there were four ED visits involving prescription opioids. Saguache County had the third highest ED visit rate in the state, placing it in the highest quintile and higher than the state rate.

Hospitalization Data and Death Certificate Data Related to Prescription Opioid Overdose

Saguache County was one of the counties where data were suppressed.

Use data with caution

Data in this report should be interpreted with caution for several reasons. First, the accuracy of the indicators based on PDMP data is limited by the completeness and quality of the data when entered into the system.

In addition, the indicators do not capture whether the dispensed medications were taken as prescribed or taken by the prescribed patient.

A more comprehensive approach and complete evaluation of the economic, environmental and societal influences is necessary to appropriately interpret

PDMP data and put the opioid epidemic into context.

Hospitalization and emergency department data are obtained through medical billing codes, which vary in their completeness.

Lastly, limitations of death certificate data may result in reporting bias. Deaths reported as multi-drug toxicity lack the specificity to know exactly what substance caused death. CDPHE does not collect toxicology reports for unintentional overdose deaths.

Prescription drug misuse is a public health crisis and the PDMP is one tool that can be used to evaluate initiatives designed to change patient and provider behavior to reduce prescription drug misuse and the associated adverse health outcomes. A balanced approach to this work includes an understanding of the need to preserve access to medications for the management of care and meeting patient expectations while decreasing the misuse and diversion of controlled substances.

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