{"id":2977,"date":"2025-08-01T01:00:08","date_gmt":"2025-08-01T05:00:08","guid":{"rendered":"https:\/\/www.ncqa.org\/?page_id=2977"},"modified":"2026-01-30T07:38:06","modified_gmt":"2026-01-30T12:38:06","slug":"use-of-opioids-at-high-dosage-hdo","status":"publish","type":"page","link":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/","title":{"rendered":"Use of Opioids at High Dosage (HDO)"},"content":{"rendered":"<p>The percentage of persons 18 years of age and older who received prescription opioids at a high dosage (average morphine milligram equivalent dose [MME] \u226590) for \u226515 days during the measurement period.<\/p>\n<h2>Why It Matters<\/h2>\n<p><span data-contrast=\"none\">The morbidity and mortality associated with opioid use has reached epidemic proportions, and is recognized by the Centers for Disease Control and Prevention, the Surgeon General and the White House as a significant public health problem in the U.S. Prescription opioid pain relievers cause nearly three out of four prescription drug overdoses<sup><a href=\"#ref-1\">1<\/a><\/sup>. The age-adjusted prescription opioid mortality rate has nearly quadrupled from 1999\u20132011, from 1.4 per 100,000 to 5.4 per 100,000. In 2011, there were 16,917 fatal overdoses involving prescription opioids<sup><a href=\"#ref-2\">2<\/a><\/sup>.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Although prescription opioids are appropriate components of a pain management treatment plan for certain conditions<sup><a href=\"#ref-3\">3<\/a> <a href=\"#ref-4\">4<\/a> <a href=\"#ref-5\">5<\/a><\/sup>. There is limited evidence demonstrating the long-term beneficial effects of opioid use for chronic pain management for nonterminal conditions<sup><a href=\"#ref-6\">6<\/a> <a href=\"#ref-7\">7<\/a><\/sup>. In addition, long-term daily use of opioids can lead to increased tolerance, addiction or dependence<sup><a href=\"#ref-8\">8<\/a> <a href=\"#ref-9\">9<\/a><\/sup>. Studies suggest a correlation between high opioid dosage and a greater risk of overdoses and fractures<sup><a href=\"#ref-10\">10<\/a> <a href=\"#ref-11\">11<\/a> <a href=\"#ref-12\">12<\/a><\/sup>.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">The 2016 CDC guideline on opioid prescribing recommends the use of \u201cadditional precautions\u201d when prescribing dosages \u226550 morphine equivalent dose (MED), and generally recommends avoiding dosages \u226590mg MED. For patients who are already taking doses \u226590mg MED, the CDC recommends that clinicians should \u201cexplain in a nonjudgmental manner\u201d the risks and benefits of continuing high-dose opioids, and should offer these patients the opportunity to taper to a safer, lower dose<sup><a href=\"#ref-13\">13<\/a><\/sup>.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">A lower rate indicates better performance.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">* Adapted with financial support from CMS and with permission from the measure developer, Pharmacy Quality Alliance (PQA).<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<h2><span data-teams=\"true\">Historical Results \u2013 National Averages<\/span><\/h2>\n","protected":false},"excerpt":{"rendered":"<p>The percentage of persons 18 years of age and older who received prescription opioids at a high dosage (average morphine milligram equivalent dose [MME] \u226590) for \u226515 days during the measurement period. Why It Matters The morbidity and mortality associated with opioid use has reached epidemic proportions, and is recognized by the Centers for Disease [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":733,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-2977","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Use of Opioids at High Dosage (HDO) - NCQA<\/title>\n<meta name=\"description\" content=\"For members 18 years and older, the rate per 1,000 receiving prescription opioids at a high dosage for \u226515 days during the measurement year (average morphine equivalent dose [MED] &gt;120 mg).\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Use of Opioids at High Dosage (HDO) - NCQA\" \/>\n<meta property=\"og:description\" content=\"For members 18 years and older, the rate per 1,000 receiving prescription opioids at a high dosage for \u226515 days during the measurement year (average morphine equivalent dose [MED] &gt;120 mg).\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/\" \/>\n<meta property=\"og:site_name\" content=\"NCQA\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/NCQA.org\" \/>\n<meta property=\"article:modified_time\" content=\"2026-01-30T12:38:06+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"627\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@NCQA\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/\",\"url\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/\",\"name\":\"Use of Opioids at High Dosage (HDO) - NCQA\",\"isPartOf\":{\"@id\":\"https:\/\/www.ncqa.org\/#website\"},\"datePublished\":\"2025-08-01T05:00:08+00:00\",\"dateModified\":\"2026-01-30T12:38:06+00:00\",\"description\":\"For members 18 years and older, the rate per 1,000 receiving prescription opioids at a high dosage for \u226515 days during the measurement year (average morphine equivalent dose [MED] >120 mg).\",\"breadcrumb\":{\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.ncqa.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Report Cards\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Health Plans\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"State of Health Care Quality Report\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Use of Opioids at High Dosage (HDO)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.ncqa.org\/#website\",\"url\":\"https:\/\/www.ncqa.org\/\",\"name\":\"NCQA\",\"description\":\"Measuring quality. Improving health care.\",\"publisher\":{\"@id\":\"https:\/\/www.ncqa.org\/#organization\"},\"alternateName\":\"National Committee for Quality Assurance\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.ncqa.org\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.ncqa.org\/#organization\",\"name\":\"NCQA\",\"alternateName\":\"National Committee for Quality Assurance\",\"url\":\"https:\/\/www.ncqa.org\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg\",\"contentUrl\":\"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg\",\"width\":876,\"height\":673,\"caption\":\"NCQA\"},\"image\":{\"@id\":\"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/NCQA.org\",\"https:\/\/x.com\/NCQA\",\"https:\/\/www.instagram.com\/ncqa_dc\/\",\"https:\/\/www.youtube.com\/@NcqaOrg\",\"https:\/\/www.linkedin.com\/company\/ncqa\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Use of Opioids at High Dosage (HDO) - NCQA","description":"For members 18 years and older, the rate per 1,000 receiving prescription opioids at a high dosage for \u226515 days during the measurement year (average morphine equivalent dose [MED] >120 mg).","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/","og_locale":"en_US","og_type":"article","og_title":"Use of Opioids at High Dosage (HDO) - NCQA","og_description":"For members 18 years and older, the rate per 1,000 receiving prescription opioids at a high dosage for \u226515 days during the measurement year (average morphine equivalent dose [MED] >120 mg).","og_url":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/","og_site_name":"NCQA","article_publisher":"https:\/\/www.facebook.com\/NCQA.org","article_modified_time":"2026-01-30T12:38:06+00:00","og_image":[{"width":1200,"height":627,"url":"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_site":"@NCQA","twitter_misc":{"Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/","url":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/","name":"Use of Opioids at High Dosage (HDO) - NCQA","isPartOf":{"@id":"https:\/\/www.ncqa.org\/#website"},"datePublished":"2025-08-01T05:00:08+00:00","dateModified":"2026-01-30T12:38:06+00:00","description":"For members 18 years and older, the rate per 1,000 receiving prescription opioids at a high dosage for \u226515 days during the measurement year (average morphine equivalent dose [MED] >120 mg).","breadcrumb":{"@id":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-opioids-at-high-dosage-hdo\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ncqa.org\/"},{"@type":"ListItem","position":2,"name":"Report Cards","item":"https:\/\/www.ncqa.org\/report-cards\/"},{"@type":"ListItem","position":3,"name":"Health Plans","item":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/"},{"@type":"ListItem","position":4,"name":"State of Health Care Quality Report","item":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/"},{"@type":"ListItem","position":5,"name":"Use of Opioids at High Dosage (HDO)"}]},{"@type":"WebSite","@id":"https:\/\/www.ncqa.org\/#website","url":"https:\/\/www.ncqa.org\/","name":"NCQA","description":"Measuring quality. Improving health care.","publisher":{"@id":"https:\/\/www.ncqa.org\/#organization"},"alternateName":"National Committee for Quality Assurance","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ncqa.org\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/www.ncqa.org\/#organization","name":"NCQA","alternateName":"National Committee for Quality Assurance","url":"https:\/\/www.ncqa.org\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/","url":"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg","contentUrl":"https:\/\/www.ncqa.org\/wp-content\/uploads\/NCQA-Blog-Logo-Thumbnail.jpg","width":876,"height":673,"caption":"NCQA"},"image":{"@id":"https:\/\/www.ncqa.org\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/NCQA.org","https:\/\/x.com\/NCQA","https:\/\/www.instagram.com\/ncqa_dc\/","https:\/\/www.youtube.com\/@NcqaOrg","https:\/\/www.linkedin.com\/company\/ncqa\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/2977","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/comments?post=2977"}],"version-history":[{"count":1,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/2977\/revisions"}],"predecessor-version":[{"id":49493,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/2977\/revisions\/49493"}],"up":[{"embeddable":true,"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/pages\/733"}],"wp:attachment":[{"href":"https:\/\/www.ncqa.org\/wp-json\/wp\/v2\/media?parent=2977"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}