Geographic Hotspots for Opioid Prescribing

Opioid prescribing rates vary dramatically across the country. Some states average rates 2-3x higher than others — patterns that have persisted for years despite national reform efforts.

Highest Opioid Prescribing States

What Drives the Variation?

• Regulation — States with stricter prescription drug monitoring programs (PDMPs) tend to have lower rates
• Demographics — Older, more rural populations correlate with higher opioid use
• Industry influence — Historical pharmaceutical marketing targeted high-prescribing regions
• Cultural factors — Pain management norms vary by region

The Persistence Problem

Despite over a decade of interventions — CDC guidelines, state monitoring programs, prescriber limits — the geographic distribution of opioid prescribing remains remarkably stable. The same states that led in 2013 largely still lead today.