Map reveals where in the US opioids are dished out for minor injuries

Your chances of being prescribed opioids for a minor injury like an ankle sprain could vary widely depending on where you live, a new study has found.

Researchers say that patients seeking medical care were on average three times more likely to be given opioids in ‘high-prescribing states’ like Georgia and Nebraska than in ‘low-prescribing states’ like West Virginia and Michigan.

The variation increased to 10 times more likely between Arkansas, where the most amount of patients were given opioids, and North Dakota, where the least amount were.

Additionally, patients who were given a 30-day-long prescription as opposed to a 10-day-long treatment were five times more likely to fill additional opioid prescriptions.

The team, from the University of Pennsylvania School of Medicine, says it hopes the findings will help prevent patients from being exposed to prescription opioids, potentially starting a cycle of addiction.

Your chances of being prescribed opioids for a minor injury like an ankle sprain could vary widely depending on where you live, a new study has found 

For the study, the team looked at private insurance claims from more than 30,800 US patients who went to the emergency room for an ankle sprain between 2011 and 2015.

They found that 25 percent of them were prescribed opioid pain medication, including drugs such as hydrocodone and oxycodone.

But the most surprising factor was the difference in how likely the patients were to be given a prescription between the states.

Although the average was three times more likely in high-prescribing states than in low-prescribing states, there were some cases where the variation was even greater.

While less than three percent of patients were given an opioid prescription in North Dakota, 40 percent were in Arkansas – making patients in the southern state 10 times more likely to receive the medication to treat their sprained ankles. 


Prescription opioids and illicit drugs have become incredibly pervasive throughout the US, and things are only getting worse.  

In the early 2000s, the FDA and CDC started to notice a steady increase in cases of opioid addiction and overdose. In 2013, they issued guidelines to curb addiction. 

However, that same year – now regarded as the year the epidemic took hold – a CDC report revealed an unprecedented surge in rates of opioid addiction.

Overdose deaths are now the leading cause of death among young Americans – killing more in a year than were ever killed annually by HIV, gun violence or car crashes.

Preliminary CDC data, published by the New York Times, shows that US drug overdose deaths surged 19 percent to at least 59,000 in 2016.

This is up from 52,404 in 2015, and double the death rate from a decade ago.

It means that for the first time drug overdoses are the leading cause of death for Americans under 50 years old.

The data lays bare the bleak state of America’s opioid addiction crisis fueled by deadly manufactured drugs like fentanyl.

The researchers say that although the samples sizes in the states may vary, it’s clear that patients are unnecessarily being prescribed these drugs. 

‘This is an indication that a lot of people are getting opiod prescriptions and there’s a lot of variation we couldn’t account for it,’ lead author Dr M Kit Delgado, an assistant professor of emergency medicine and epidemiology at Penn, told Daily Mail Online.

‘The study shows there’s room for improvement in terms of who we prescribe opioids to, especially for people whom have never been exposed before.’

The team also found a difference between patients who received a long-course drug treatment, such as prescribed more than 30 oxycodone tablets, and those who were given a short-course treatment, such as 10 tablets or fewer.

The long-course patients were five times more likely to fill more opioid prescriptions over the next six months than the short-course patients. 

Researchers say that the average prescribing rate was around 24 percent. If all the above-average states were brought down to the average rate, 18,000 fewer opioid tablets would be prescribed, they say. 

But overall prescribing had decreased, the researchers found, with 20 percent of ankle sprain patients receiving an opioid prescription in 2015 compared to 28 percent in 2011.

The authors hope the findings encourage doctors to find alternatives for pain management and to prescribe opioids only if absolutely necessarily and in the smallest doses, between 10 and 12 tablets.  

‘There’s many more things you can do to try to alleviate pain from an ankle sprain such as ibuprofen and other anti-inflammatory medicines,’ said Dr Delgado.

‘Even though there’s been some push back to cut back on opioid prescribing, this is not something that should be prescribed to most people.’