South and Midwest Lead U.S. in Opioid Prescribing

South and Midwest Lead U.S. in Opioid Prescribing

Over twice as many prescriptions for opioid painkillers are written for patients in the South and Midwest than in other parts of the country – according to a new Vital Signs report released by the Centers for Disease Control and Prevention.

img6Alabama, Tennessee, and West Virginia lead the nation in opioid prescribing, with at least 138 prescriptions written for every 100 people in 2012.

Fewer than 60 prescriptions for opioids were written for every 100 people in New York, Hawaii and California.

The CDC says the variation in prescribing rates “cannot be explained by the underlying health status of the population.” It analyzed 2012 prescribing data from retail pharmacies collected by a commercial vendor, and calculated prescribing rates by state for various types of opioid painkillers.

Nationwide, 259 million prescriptions for opioid painkillers were written in 2012, enough for every adult American to have a bottle of pills. The CDC estimates that 46 people died daily from painkiller overdoses that year.

“Prescription drug overdose is epidemic in the United States. All too often, and in far too many communities, the treatment is becoming the problem,” said CDC Director Tom Frieden, MD. “Overdose rates are higher where these drugs are prescribed more frequently. States and practices where prescribing rates are highest need to take a particularly hard look at ways to reduce the inappropriate prescription of these dangerous drugs.”

One state that’s been successful in reducing the number of overdoses is Florida, where a crackdown on “pill mills” and doctors who overprescribe opioids began in 2010. About 250 pain clinics have been closed in Florida and the number of high-volume oxycodone dispensing prescribers declined from 98 in 2010 to zero in 2013.

From 2010 to 2012, the number of drug overdose deaths in Florida fell 16.7%, from 3,201 to 2,666. The decline in overdose deaths from oxycodone alone was over 52%, far exceeding the decline in deaths from all other opioid pain relievers.

“The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities,” the CDC said in a separate report.

The report does not mention the severe impact the crackdown has had on legitimate pain patients in Florida, many of whom have difficulty getting their opioid prescriptions filled by pharmacies.

“All politicians care about is the numbers and screw all the legitimate pain patients who can’t get anything filled. I am hearing from legit patients who are suffering so badly with no medicines because of the state government here,” said Donna Ratliff, a Florida pain patient and activist in an email to National Pain Report.

“Florida’s legitimate pain patients are withdrawing, waiting weeks for medicines, and some patients are being cut in doses of their medicines by their doctors so severely. One man has even had 6 discs removed from his back along with 4 herniated discs that are still there. His doctor cut his medicines in half in one month! The man is in terrible pain. I really feel that the representatives of Florida are patting their selves on the back for success and don’t care what’s happening to these poor people!”

Some researchers have questioned the validity of much of the data used to estimate the number of prescription drug overdoses deaths, saying they have identified “significant limitations in the evidence base.”

Authored by: Pat Anson, Editor

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Its Illegal for any pharmacist to look at your medical records/MRI’s etc it’s a direct violation of Hippa laws and you do not have to show them anything. REPORT THEM.

I fear the with far fewer investigations into the “marijuana” issue that the DEA will continue to haunt pain patients even more than in the past.


in west palm beach there is not 1 pharmacy that will fill schedule 2 pain meds.I pay for my doctor visits since insurance stopped paying and pay for scripts.It has been over a year since I had a script filled with the exception of 60 exaldo .Insurance does not cover exaldo .cash cost 1580$ .I do not know what to do next,any thoughts?

I hope and pray that the crackdown on opioids is done by looking at the records and hunting down the “mills” and the patients actually misusing their scripts. It’s not that hard to find the cheaters. they leave a paper trail. Just, please leave the legit patients alone and they are easier to spot. There is a true and exact paper trail.
So DEA …do what you were trained to do, and do it right this time. Your rules forced me into a bed, permanently, the last go around and I was doing damn good at the time. You owe me this. Do it Right!!!

Stephen M

259 million prescriptions isn’t enough. One bottle per adults still leaves so many unprotected. The average pain patient needs 24 prescriptions per year (maintenance & breakthrough medication x12 months), that leaves all children and 3 out of 4 adults with chronic pain undertreated (chronic pain affects 1 in 3).


I have loss of disc height and super imposed disc herniation indents the anterior thecal sac, loss of hydration ,disc bulges , with the spondylosis , with severe compression of nerve roots , plasticity in bone marrow and red bone marrow transformation in spin , neck injuries and more my pain level on my prior pain medicine was about a 5 with out 8 -10 and drives me to the point of insanity , I was denied my pain medicine for 5 months left to suffer like a dog ran over by a car the pain was unbearable and still is and thought about killing myself a number of times I know if I was a dog laying in the street run over by a car someone would put me out of my pain or give that dog something so it would not suffer , not much to say about a pain patient is it . I was recently given pain medication the pharmacist said she would give me the lowest dose or I would get nothing at all seem like the ( pharmacist dispenser) is now the doctor, it took years for a doctor to find out what works on my pain and that work is thrown out the window , and also the pharmacists are saying they are doctors they took another other classes for credits a doctorate in pharmacy ? but they are not in internal medicine it is against the lay to impersonate a licensed physician so why are they changing my prescription ,is it to make me suffer, I also have been treated like it was wrong to be hurt, told the did not want my kind in a pharmacy, what kind do they not want someone with a disabling condition, I know many that are made to suffer every day, the day I was told I might have cancer I was in so much pain and I talked to a pharmacist about my condition and you know what she did to help me ? Denied my prescription I feel afraid to go to the pharmacy and do not trust the pharmacist ,what a world not caring about the suffering of others. just moving up the corporate ladder the pharmacist will sure fill the uncontrolled when they get their hands on them even lie to be able to fill them, and not fill the controlled , that is really sick someone who is suppose to be medically treating you and took a oath, lie to that patient and that medication is to be filled together for pain management treatment, I have pages of MRI’s I am in so much pain it makes me cry and wish I was not on this earth the pain medicine did not make the pain go away but dulled it enough to want to live and go on day to day I do not know how much I can take , this is not a game it is debilitating my… Read more »

This superficial decline in pain pill deaths here is Florida is exaggerated, I’m sure.
The oxicontin deaths that were splattered all over the media several years ago never divulged that most of the deaths were from poly-drug use, meaning that other drugs were used in combination (valium, soma, etc.) that, no doubt, assisted in their deaths. The stats are always “cooked” to their advantage, especially when it’s an election year. It sounds better to “forget” to add the circumstances, it fit in their little news story to lead out with “another oxicontin overdose.” That way it sounds like our Gov’nor is cracking down on drug use & shutting down the pill-mills when in reality the good, caring legit doctors are running scared from the DEA & the pain patients, AGAIN, pay the price.

I would like to bring back an old chant that was used in the Viet Nam era for LBJ, only let’s change the words to fit the situation.
“Hey, Governor Scott, HEY!
How many pain patients did U kill today?”

SMH, it’s nothing to be proud of, for every druggie U stopped, I wonder how many pain patients suffered or even died?

Sign me,

Donna Ratliff

I saw the CDC information on the evening news and it looked to me as though the politicians were proud of them selves. Not one word said about the crisis of legitimate pain patients who are being denied the medicine at pharmacies and how doctors are cutting doses in harmful ways. The news station I listen to said at the very end of segment, that heroin has doubled here in FL.

I would suggest we change the conversation by calling the news and ask them why they forgot about mentioning anything about all the disabled people suffering and that they are being denied.

I am with Pharmacist Steve on all of us filing ADA complaints! Read his blog for more information on this.

I know the AG in FL Pam Bondi is using this be re-elected. I surely hope that anyone with pain or that has a loved one with pain definitely votes her OUT. Our Governor is just as bad, vote him OUT too. Not ONE Florida state Rep has supported our cries for help in the past 3 years here. WE have done everything and they know what is happening, believe me. hey do not care!

As for anyone not having issues in your state? It will be soon, so get ready.

This fake epidemic is out of control and I do agree on investigating the DEA.

We, those who are in pain, need to ban together and fight this discrimination if we are ever going to have a life. It will have to be pain patients and their supporters to make the changes needed or this will never end. I read not long ago some one said, that all Pain Foundations- (groups) should be talking of how we can fix all this, not just talking about pain awareness and whining about it.

We know what pain is. WE need to change our futures and now!

They, Our politicians and the DEA are on a roll now and will NOT stop unless we stop them.

We need to do this together. Strength is in numbers!


We need DEA reform in a bad way. If pharmacist are going to deny us pain medication then they need more education on conditions and injuries. I’m so tired of a pharmacy asking for MRIs and they have no clue what they mean. Pharmacy association needs to step in and come up with a diagnose system and clear legitimate patients right to treatment they choose. If they don’t want to obtain more education. This is unfair to both parties. I’m glad a lot of you don’t have a problem getting your meds filled but there are just as many who CANT. Our pain consumes most of our life’s as it is and if you don’t abuse and don’t come early and have shown years of no problems leave us alone. so we can have some quality of life. We did not ask to be in pain and I’m sure would give the pills up if life could be pain free I know I would in a second. Politicians need to stop calling our shots and we need to weave the ones out who don’t care about pain or have the attitude were just junkies and need a fix. Patients are going to have to be the front and advocates for pain treatment. I would like to see overdose ruling changed to if patients have alcohol or illicit drugs in there systems to be put into another category not opioids overdose only. Because that’s false information and is why all this crap is going on.


Terry, you are exactly right with your succinct comments as opposed to my short narrative! You describe my life right now. I’ve been held at the same level of pain medication for almost 4 years now because the doctor has established his own personal policy as to the maximum he will allow regardless of any patients level of pain. As a result I live as shut in and as you described can barely walk and must rely upon others to do things for me since I live alone. I have no quality-of-life and my only reason to stay alive is to watch my two kids grow up. Thank you for your well worded summary of the issue for real chronic pain patients.


Keep checking information that the lies came from. A lot of the deaths are not just from opioids. Alcohol and other drugs helped contribute to the deaths about time someone started looking. Florida legit patients are suffering and I’m sure other area too. Human Rights should be stepping in this inhuman suffering that should not be happening. You have records to prove your conditions end of story let you have your meds.

Trudy McGee

The report also does not mention how heroin has become an epidemic either!!! It does not mention how many people are dying of overdoses from heroin. This is not a stop the drug solution, but a society mental health solution. To make the innocent suffer is just plain wrong!


I’ve had chronic pain for 12 years now. It’s 24/7 and my eyes, upper cervical spine and the back of my head around my brainstem… Pain never goes away. As a result I’ve lost my job, my wife, my kids and my home. I’ve seen every specialist there is including the Cleveland clinic and the most recent diagnosis is upper cervical facet disease causing the brainstem and eye pain (referred pain). I was introduced to Vicodin approximately four years into the pain. I also was prescribed several other types of short-term pain medications. It wasn’t until my pain doctor prescribed OxyContin twice a day that I had longer-term relief that I believe allowed me to work two more years that I would otherwise have not been able to do. That’s two years of productivity/contribution to GDP that without a long-term acting opiate I would’ve had to go on disability sooner. But as most people know there’s a limit to taking any type of opiate and at that limit I could no longer work due to the pain I mentioned above so basically my employer approached me and even though I had communicated my condition throughout the years I was told that everyone wanted the “old me”back. And I could not have agreed more but it was completely beyond my control. So why my story you wonder? There is clearly a high-level, generalized battle against the prescribed opiates necessary for people like me to keep from going to the emergency room every day. When you talk about this subject there is a big difference between being dependent versus being addicted. I am dependent because I have taken the opiates for eight years and I have taken them exactly as prescribed. If laws are passed to further deter prescriptions of the opiates that I need what are my alternatives? Illegal drugs? Right now, I live alone in an apartment that I never leave except when I must go see the doctor and in half of those cases I am successful in finding a service that will give me a ride. I need for opiates have to be case-by-case and scaring doctors away from prescribing them will only hurt the economy and the individual and the short and long-term. My quality of life sucks but at least I’m alive to see my children grow up and I avoid the emergency room only because of the long term acting opiates prescribed to me from my doctor. I have major depressive disorder because of this pain and that my neurosurgeon told me will only get progressively worse and there’s nothing surgically he can do for me. I’ve read that patients with this type pain often kill themselves thus dubbing the pain symptoms of a type of “suicide disease” since it’s the worst pain that neurosurgeons say a human could endure. So please don’t use simplified geographical data as the basis for enacting laws or for the DEA to pick up and pressure more doctors and… Read more »


I would also like to know how the rate of suicide among chronic pain patients has changed during the same time period, due to their being thrown into withdrawal by suddenly ending their access to the medicine they need to be able to manage their pain. And how many patients are now bedridden because without pain medication, to just move causes them unbearable pain. How many now feel useless because not only are they prevented from pursuing activities that they enjoy, and that make life worth living, but because of their unmitigated pain they struggle just to drag themselves to the bathroom or the kitchen to take care of their most basic needs.

Now we are in a heroin epidemic!!