The Medicare Opioid Crisis in Numbers
The opioid epidemic remains one of America's deadliest public health crises. Our analysis of the complete 2023 Medicare Part D prescribing dataset reveals the staggering scale of opioid prescribing among Medicare providers.
450,343
Opioid Prescribers
33%
Of All Prescribers
113,169
High Rate (>20%)
156
Specialties Prescribing
One in Three
Out of 1,380,665 Medicare Part D prescribers, 450,343 (33%) prescribed at least one opioid in 2023. That's roughly one in every three providers.
Among those, 113,169 providers have opioid prescribing rates above 20% — meaning more than one in five of their prescriptions are for opioids. CMS considers 20% an elevated threshold.
Geographic Concentration
Opioid prescribing rates vary dramatically by state:
| State | Avg Opioid Rate | High-Rate Providers |
|---|---|---|
| Armed Forces Pacific | 25.1% | 13 |
| Foreign/Unknown | 21.2% | 12 |
| Unknown | 17.7% | 2 |
| Utah | 17.1% | 1,343 |
| Colorado | 17.1% | 2,670 |
| Missouri | 17.0% | 2,493 |
| Alabama | 16.6% | 2,064 |
| Armed Forces Europe | 16.4% | 10 |
| Arizona | 16.0% | 2,548 |
| District of Columbia | 16.0% | 296 |
What This Means
Not all opioid prescribing is inappropriate — pain management specialists, oncologists, and palliative care providers legitimately prescribe opioids at high rates. But the sheer volume suggests the pipeline remains enormous, even as national efforts aim to curb unnecessary prescribing.
The key question isn't just how much but where and by whom. Geographic hotspots and specialty patterns point to systemic issues that blanket regulations miss.