After St. Francois County officials passed an ordinance last year to establish a prescription drug monitoring program (PDMP) in the county and to subscribe to the larger system established in 2016 by the St. Louis County Department of Public Health, numbers have been released outlining the trends of controlled substance prescription by residents of St. Francois County.
In a report detailing data obtained in the fourth quarter (Q4) of 2017 (October-December), the distribution information of St. Francois County residents is compiled and compared to program averages and similar data from other counties for the first time since the county joined the system. The report states that, as the data is only from one quarter of a year, the “findings are not necessarily indicative of average prescribing practices in St. Francois County.”
The report includes projected annual rates for the county based on one quarter’s worth of data.
The data is presented in prescriptions per 1,000 population, with the distribution rate of the entire system being 1,574.4 prescriptions per 1,000 population. The report states that in the selected time period, St. Francois County residents received the highest rate of controlled substance distributions in the system, with 2,401.1 prescriptions per 1,000 population.
Following St. Francois County, the highest distribution rates were found in residents of Pemiscot County, Madison County, Jefferson County, Lincoln County, Butler County, St. Charles County, City of Independence, Wayne County, Jackson County (excluding Kansas City and Independence), Benton County and Ste. Genevieve County.
The lowest distribution rate in the system was found in residents of McDonald County, with a rate of 734.6 prescriptions per 1,000 population.
The report further breaks down the distribution rates among demographics within St. Francois County, first by gender.
The report shows that females in St. Francois County receive prescriptions of controlled substances at a rate of 2,954.4 prescriptions per 1,000 population, while St. Francois County males receive 1,871.6 prescriptions per 1,000 population. Both the female and male populations of St. Francois County received prescriptions at significantly higher rates than the respective female and male populations of the system at-large.
The report next shows the Q4 distribution rates by age in St. Francois County, showing that controlled substance prescription rates increase with age until after the 55-64 age range, at which point they begin to decline.
The 55-64 age range had the highest rate at 5,515 prescriptions per 1,000 population, compared to the system total of approximately 3,000 per 1,000 population. All age groups in St. Francois County display higher rates of controlled substance prescription compared to the system population, with the exception of the 18-24 age range, which was slightly lower than the system total.
When age and gender is combined, females aged 55-64 in St. Francois County displayed the highest distribution rate at 6,371.8 prescriptions per 1,000 population. Males in the same age range in St. Francois County received prescriptions at a rate of 4,589.8 prescriptions per 1,000 population.
Opioid drugs are the most highly prescribed schedule II-IV controlled substances in the system in St. Francois County, accounting for 40 percent of all dispensed controlled substances, followed by Benzodiazepine.
The total system’s distribution rate for opioids was 687 prescriptions per 1,000 population, while St. Francois County’s rate was again the highest in the system at 1,224.7 opioid prescriptions per 1,000 population. McDonald County receive opioid prescriptions at the lowest rate in the system at 416.2 per 1,000 population.
Opioid prescriptions by age in St. Francois County increases progressively as age increases, again until after the 55-64 age range at which point the numbers decrease in the 65+ age range. The largest increases are between less than 18 to 18-24 (460 percent increase) and 18-24 to 25-34 (156 percent increase).
The data in the report shows that low-dose opioids are the most prescribed opioids, with distribution rates decreasing as the dosage increases.
The most prevalent opioid prescription was for Hydrocodone, followed by Oxycodone and Tramadol. These three opioids make up 84 percent of all dispensed opioids in St. Francois County in that quarter.