The more than decade-long decline in opioid dispensing continued from 2019 through 2025, with total opioid doses dropping by an average of 7.6% per year, according to a study published in JAMA.Why It’s Relevant
Nationally, fatal overdoses caused by prescription opioids have been falling since 2022, decreasing by 20% from 2023 to 2024. Understanding why this trend has occurred is vital to ensure it continues and to better address the needs of those who continue to struggle with opioid use disorder.
By the Numbers
- Researchers used IQVIA’s Xponent data, which captures 94% of prescriptions dispensed from U.S. retail pharmacies.
- From 2019 to 2025, the average annual opioid dose per person declined from 400.8 to 247.8 morphine milligram equivalents (MME), or about 7.6% per year.
- During the same time, overall opioid dispensing decreased by 5.2%, from 46.8 to 33.7 prescriptions per 100 persons, while the dispensing of extended-release or long-acting formulations declined by 8.8%.
- High-dose (≥50 MME per day) and long-duration prescriptions (≥30 days) decreased by 8.5% and 6%, respectively.
What’s More
While 76% of counties experienced a decline of 10% or more in MME per person, 15.4% experienced an increase of 10% or greater. There was substantial county-level variation in opioid dispensing changes, particularly along rural/urban lines. Rural counties accounted for 62% of counties that experienced increases in dispensing.
The Other Side
The data did not include mail-order or clinician-dispensed prescriptions, nor did it capture the clinical characteristics of patients. Additionally, the study only analyzed prescription opioid data and does not include nonprescription or illicit sources.
Takeaway Message
The study provides some context for overall trends in the opioid epidemic, write the authors of an accompanying commentary. “[M]any patients report leftover opioids after receiving opioid prescription treatment for acute pain,” they wrote. The geographic variation in opioid dispensing identified in the study, “may explain why overdose mortality risk remains elevated compared with a decade prior.”
Related Information
Source
Lyna Schieber, et al. National and county-level trends in opioid dispensing. JAMA. Published October 21, 2026. doi:10.1001/jama.2026.19469
(Image: Getty Images/iStock/DEBBY LOWE)
