What is already known about this topic?
Opioid prescribing rates vary by county urbanization level and are declining overall.
What is added by this report?
Analysis of patient opioid prescription data from a national electronic health record vendor during 2014–2017 found that the percentage of patients prescribed an opioid was higher in rural than in urban areas. Significant decreases in opioid prescribing occurred across all urban-rural categories after the March 2016 release of the CDC Guideline for Prescribing Opioids for Chronic Pain.
What are the implications for public health practice?
As less densely populated areas indicate both progress in decreasing opioid prescribing and need for ongoing reduction, tailoring community health care practices and intervention programs to community characteristics will remain important.