Trend in Opioid Analgesic Prescriptions and High‐Risk Prescribing in the State of Illinois: An Eight‐Year Descriptive Analysis

ABSTRACT Objective Given the significant opioid epidemic in the United States, we investigated opioid‐analgesic prescription trends and high‐risk prescriptions in Illinois between 2015–2022. Methods Data from the Illinois Prescription Monitoring Program were analyzed for opioid prescription rates and high‐risk prescriptions (i.e., multiple‐prescribing providers, concurrent benzodiazepine, ≥ 90MME dose). Demographics (sex, age, and rural/urban classification using the Illinois Primary Health Care Association‐2020) of high‐risk prescriptions between 2018–2020 were analyzed using chi‐square tests. Results N = 45,522,885 opioid prescriptions were dispensed in Illinois between 2015–2022, declining by 47.1% (from 140.5 rate in 2015 to 74.4 in 2022). High‐risk prescriptions comprise 12.6% of all prescriptions and decreased by 16.6% (from 16.9% in 2015 to 14.1% in 2022). Between 2018–2020, males received more high‐risk prescriptions than females, although both males and females showed a reduction in ≥ 90MME prescriptions (19.5% vs. 15.9%, p < 0.0001) and multiple‐provider prescriptions (36.1% vs. 27.3%, p < 0.0001). Individuals aged 56–70 received the highest high‐risk prescriptions, while reductions in ≥ 90MME prescriptions occurred across all age groups. High‐risk prescriptions were disproportionally dispensed in rural areas (67.8%), where reductions were greater in ≥ 90MME prescriptions (16.7% rural vs. 6.4% urban) and multiple‐provider prescriptions (9.0% rural vs. 7.9% urban). Conclusions Despite declines in opioid‐analgesic prescriptions in Illinois from 2015 to 2022, high‐risk prescribing persists, particularly in rural areas and among specific demographic groups. Targeted, region‐specific interventions and continued regulatory oversights are necessary to address geographic and population‐level disparities in high‐risk opioid prescribing.