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Declining Opioid Distribution to US Hospitals

The United States is enduring a preventable opioid crisis, particularly involving a population specifically being treated in a hospital setting. This project analyzed trends in distribution of opioids by hospitals in the United States from 2000 to 2019. Opioids monitored included buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, powdered opium, remifentanil, and tapentadol. The Automation of Reports and Consolidated Orders System (ARCOS) reports controlled substances via the Drug Enforcement Administration (DEA). Data from ARCOS reports 5 and 7 from 2000 to 2019 were utilized for an observational study on hospital opioid distribution in the US. Morphine milligram equivalents (MME) were calculated using oral conversion factors for each opioid. The MME per person per state was calculated to compare data from the peak year, 2012, to data from 2019. Opioid use in the United States peaked in 2012 with a 46.6% decline from 2012 to 2019. Within the US, 25 of 50 states have seen a decrease of 50% or greater. Of the opioid compounds observed, buprenorphine has seen increased (123%) hospital use from 2000 to 2019. All other opioids have been experiencing a slow decline (>40%) in hospital use since that time. This study demonstrated the progress made thus far by hospitals in curbing the US opioid epidemic.