The United States is enduring a preventable opioid crisis, particularly involving a population being treated in a hospital setting, a subset of whom may escalate to illicit opioids. This project analyzed trends in distribution of opioids by hospitals in the United States. Opioids monitored included buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, powdered opium, remifentanil, and tapentadol. The Automation of Reports and Consolidated Orders System (ARCOS) reports controlled substances via the Drug Enforcement Administration (DEA). National data from ARCOS reports 5 and 7 from 2000 to 2019 were utilized for an observational study on hospital opioid distribution. Morphine milligram equivalents (MME) were calculated using oral conversion factors. The MME per person per state was calculated to compare data from the peak year, 2012, to data from 2019. Opioid use peaked in 2012 with a -46.6% decline from 2012 to 2019. Half (25) of states have seen a decrease of -50% or greater. Of the opioid compounds observed, buprenorphine has seen increased (+122.5%) hospital use from 2012 to 2019. All other opioids have been experiencing a decline (>50%), particularly hydromorphone (-49.9%), oxymorphone (-57.7%), methadone (-58.7%), morphine (-66.9%), codeine (-67.5%), and meperidine (-77.6%). There was a six-fold difference in population corrected use of opioids in 2019 between the lowest (6.8 MME/person in New Jersey) and highest (Alaska = 39.6) states. This study demonstrates the considerable progress made thus far by hospitals in curbing the US opioid crisis.

中文翻译：

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美国医院阿片类药物分配的下降和地区差异。

美国正在经历一场可预防的阿片类药物危机，特别是涉及在医院接受治疗的人群，其中一部分人可能会升级为非法阿片类药物。该项目分析了美国医院阿片类药物的分配趋势。监测的阿片类药物包括丁丙诺啡、可待因、芬太尼、氢可酮、氢吗啡酮、哌替啶、美沙酮、吗啡、羟考酮、羟吗啡酮、鸦片粉、瑞芬太尼和他喷他多。报告自动化和综合订单系统 (ARCOS) 通过缉毒局 (DEA) 报告受控物质。2000 年至 2019 年 ARCOS 报告 5 和 7 的国家数据被用于医院阿片类药物分布的观察性研究。吗啡毫克当量（MME）是使用口服换算系数计算的。计算每个州人均 MME 的目的是将 2012 年高峰年的数据与 2019 年的数据进行比较。阿片类药物使用量在 2012 年达到峰值，从 2012 年到 2019 年下降了 -46.6%。一半 (25) 的州的阿片类药物使用量下降了-50% 或更高。在观察到的阿片类化合物中，从 2012 年到 2019 年，丁丙诺啡的医院使用量有所增加 (+122.5%)。所有其他阿片类药物的使用量都在下降 (>50%)，特别是氢吗啡酮 (-49.9%)、羟吗啡酮 (-57.7%) 、美沙酮 (-58.7%)、吗啡 (-66.9%)、可待因 (-67.5%) 和哌替啶 (-77.6%)。2019 年，人口校正的阿片类药物使用率最低（新泽西州为 6.8 MME/人）和最高（阿拉斯加州 = 39.6）的州之间存在六倍的差异。这项研究表明医院迄今为止在遏制美国阿片类药物危机方面取得了巨大进展。