OBJECTIVES: The opioid epidemic has been an ongoing public health issue impacting patient outcomes and healthcare costs. In this study, we demonstrate the prescribing trends of new electronic prescriptions (e-prescriptions) for opioid drugs and non-opioid alternatives during 2019 - 2023. Additionally, we describe the trends in prescribing of opioid antagonists during the same period.

METHODS: Data was retrieved from Surescripts, a national health network connecting providers, Electronic Health Records (EHRs), pharmacy benefit managers (PBMs), pharmacies, and health technology vendors. In 2023, prescribers used the Surescripts network to send 2.5 billion e-prescriptions. The World Health Organization Anatomical Therapeutic Chemical (ATC) Classification was used to define therapeutic classes of pain medications. We identified new e-prescriptions of opioids and non-opioids, comprised of ‘analgesics’ and ‘anti-inflammatory and antirheumatic products’, and opioid antagonists. We excluded medications that are FDA approved to treat colds and migraines, which we identified using their generic name.

RESULTS: Opioid analgesics accounted for 99.8% to 99.9% of opioids e-prescribed in 2019, 2020, 2021, 2022, and 2023, respectively. The number of new e-prescriptions for opioids grew by 57.1% from 2019 to 2020, 26.0%, 7.8% and 5.1% from 2020-2021, 2021-2022, 2022-2023, respectively. Meanwhile, the number of new e-prescriptions for non-opioids increased by 2.2% from 2019 to 2020, and then grew by 12.9%, 13.2%, and 9.3% from 2020-2021, 2021-2022, and 2022-2023, respectively. Non-opioid analgesics accounted for 23.1%, 27.7%, 28.2%, 28.8 and 28.5% of non-opioids e-prescribed in 2019, 2020, 2021, 2022, and 2023, respectively. New e-prescriptions for opioid antagonists grew by 63.9%, 29.3%, 10.7% and 5.7% from 2019-2020, 2020-2021, 2021-2022, 2022-2023, respectively.

CONCLUSIONS: The year-over-year growth in opioid e-prescribing slowed from 2019 to 2023, coinciding with a slowed growth in the prescribing of opioid antagonists during the same period. The year-over-year growth in non-opioid e-prescribing was higher from 2020-2023 compared to the 2019-2020 year-over-year growth.