In October 2017, the Trump administration declared the opioid epidemic a national emergency. Since then, the government has yet to bring forward new resources or strategies as a response.

To help policymakers better understand how their constituents are dealing with the opioid crisis, a team of researchers conducted the first-ever study on opioid prescribing rates at the Congressional district level.

“There is value in constructing district-level rates,” wrote Lyndsey A. Rolheiser, PhD, of the Center for Population and Development Studies at Harvard University and colleagues in their paper published in the American Journal of Public Health. “Leaders in Congress are typically more familiar and concerned with constituents in their own districts….Using our analysis, policymakers can understand how their districts are faring relative to other districts across the country and within their state.”

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Dr Rolheiser and colleagues found that the lowest prescribing rates were concentrated in urban areas, and the highest rates were districts in the South, Appalachia, and the rural West. The data also showed some outliers in areas where prescribing rates fell far below the national average.

“The most surprising was the amount of variation that exists between and within states,” said Dr Rolheiser. “The [contrast between the] upper peninsula of Michigan and a neighboring district in Wisconsin was surprising, given the similar demographics of the two districts.”

Southern states have the 10 highest prescribing rates in the country, while California, New York, and Virginia are among the bottom 10.

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“This paper is simply the first step in Congressional district analysis,” Dr Rolheiser said. “Now that we have created estimates at the district level, we hope to complete more complex analysis of issues pertaining to the opioid crisis and hope that other researchers and policymakers will find our data useful.”


Rolheiser LA, Cordes J, Subramanian SV. Opioid prescribing rates by Congressional districts, United States, 2016. Am J Public Health. 2018;108(9):1214-1219.