Exploring Opioid Prescription Patterns and Overdose Rates in South Carolina (2017-2021): Insights into Rising Deaths High-Risk Areas

Abstract

With opioid overdose rates on the rise, we aim to develop a county-level risk stratification, specifically focusing on access to Medications for Opioid Use Disorder (MOUD) and high overdose rates. We examined over 15 million records from the South Carolina Prescription Tracking System (SCRIPTS) across 46 counties. Additionally, we incorporated data from opioid treatment programs, healthcare professionals prescribing naltrexone, clinicians with buprenorphine waivers, and county-level overdose fatality statistics. To assess the risk of opioid misuse, we classified counties into high-risk and low-risk categories based on prescription rates, overdose fatalities, and treatment service availability. Utilizing statistical methods, we compared prescription patterns and outcomes between these groups. Our study shows that between 2017 and 2021, opioid prescriptions decreased from 64,223 to 41,214 per 100,000 residents, while fentanyl-related overdose deaths increased by 312%. High-risk counties have significantly higher rates of fentanyl prescriptions and rely more on out-of-state doctors. They also exhibit higher instances of doctor shopping and had fewer medical doctors per capita, with limited access to MOUD. To effectively combat the opioid crisis, we advocate for improved local healthcare infrastructure, broader treatment access, stricter management of out-of-state prescriptions, and vigilant tracking of prescription patterns. Tailored local strategies are essential for mitigating the opioid epidemic in these communities.