OBJECTIVES: To address the opioid epidemic in the US, the Pharmacy Quality Alliance (PQA) recently developed quality measures of inappropriate prescription opioid use that address 1) high-dose use, 2) receipt of prescriptions from multiple providers, and 3) concurrent benzodiazepine use. Our objective was to examine the patterns of inappropriate opioid use among disabled Medicare beneficiaries across regions from 2011 through 2013. METHODS: Among 195,101 non-cancer, disabled Medicare patients who had >2 opioid prescriptions, we identified patients with high-dose use (>120 daily morphine milligram equivalents for ≥90 consecutive days) and multiple providers (having prescriptions from ≥4 prescribers and ≥4 pharmacies) each year; and concurrent benzodiazepine use (≥30 cumulative days) in 2013 when Part D began coverage for benzodiazepines. We used multivariable logistic regression to obtain adjusted annual rates of problematic opioid use across 306 hospital referral regions (HRRs), adjusting for sociodemographic, health status, and access-to-care factors. RESULTS:  Adjusted annual rates of high-dose use (~9%) and having multiple providers (~5%) remained stable over three years. In 2013, 32.9% of beneficiaries used benzodiazepines concurrently. The ratios of 75^th percentile to 25^thpercentile rates of inappropriate use across HRRs were 1.88 for high-dose use, 1.78 for having multiple providers, and 1.38 for concurrent benzodiazepine use. The top 5 HRRs with the highest rate of high-dose use were Sun City, AZ(16.6%), Sarasota, FL(16.2%), Lawton, OK(15.5%), Pueblo, CO(15.5%), and New Brunswick, NJ(14.8%); of multiple providers were Arlington, VA(11.2%), St Cloud, MN(7.7%), Pueblo, CO(7.3%), Anchorage, AK(7.2%), and St. Paul, MN(6.9%); and of concurrent benzodiazepine use were Slidell, LA(49.8%), Miami, FL(49.5%), Clearwater, FL(47.3%), Detroit, MI(46.1%), and Paterson, NJ(46.0%). CONCLUSIONS: Substantial concurrent benzodiazepine use and geographic variation in problematic prescription opioid use exist among disabled Medicare beneficiaries. Areas with high rates of problematic use may benefit from targeted interventions (e.g., lock-in programs) to reduce inappropriate opioid use.