​Among disabled Medicare beneficiaries, county-level socioeconomic factors are associated with opioid prescriptions, with more prescriptions seen with lower socioeconomic indicators, according to a study published in the January issue of Medical Care.

Chao Zhou, Ph.D., from the Health Care Cost Institute in Washington, D.C., and colleagues examined opioid prescriptions of disabled Medicare beneficiaries without record of cancer treatment, palliative care, or end-of-life care using complete 2014 Medicare enrollment and part D drug prescription data. The authors examined the demographic and geographic variation and the correlation between the local economic environment and measures of individual opioid prescriptions.

The researchers found that for disabled Medicare beneficiaries there were consistent correlations for lower county median household income, higher unemployment rates, and less income inequality with more and higher average morphine milligram equivalent opioid prescriptions. The urban-rural divide was not gradual; the likelihood of having an opioid prescription was lower for beneficiaries in large central metro counties versus those living in other areas.

"There was substantial demographic and geographic variation in measures of opioid prescribing," the authors write. "People at greatest risk for potentially harmful use live in communities outside inner cities with lower median household incomes, higher unemployment rates, and a lower Gini index."