Disclosures: King J. Pascual, MAT: No financial relationships or conflicts of interest

Objective: To test the hypothesis that U.S. states with higher volumes of internet searches regarding non-pharmacological and complementary pain interventions are more likely to be associated with lower statewide levels of opioid prescriptions.

Design: Non-experimental, observational Setting : N/A Participants : N/A

Interventions: 2017 State opioid prescription level data was obtained from the CDC. Google TrendsTM was used to extract 2017 search volume indices (SVIs) for keywords related to CBD, medical marijuana, mindfulness, acupuncture, and chiropractic therapy. A comparison of means test was conducted to determine statistical significance.

Main Outcome Measures: 2017 state level of opioid prescriptions per 100 persons and 2017 Search Volume Indices (SVIs) for the keywords “medical marijuana”, “mindfulness”, “acupuncture”,”chiropractic therapy”, and “CBD.”

Results: Of the 29 states where medical marijuana was legalized as of 2017, the 5 states with the highest and lowest SVIs for medical marijuana-related online searches were associated with mean ± SD opioid prescribing levels of 64 ± 13 and 43 ± 11 per 100 persons, respectively (p=0.02). When looking at all 50 states nationwide, the 15 with the highest and lowest online SVIs related to “mindfulness” searches showed even greater statistical significance with mean ± SD opioid prescribing levels of 50 ± 10 and 70 ± 14 per 100 persons, respectively (p < 0.001). We also found decreased levels of opioid prescription for states that displayed the highest SVIs for searches related to acupuncture (p < 0.001) and chiropractic therapy (p < 0.004), compared to states with the lowest SVIs. However, opioid prescription levels did not differ between states with the highest and lowest SVIs related to CBD product searches. Conclusions: Google TrendsTM may serve as an additional epidemiological tool for opioid overprescription in the United States. Encouraging information-seeking behavior toward certain non-pharmacological and complementary options for acute and chronic pain should be considered as part of a broader public health effort to curtail opioid overprescription and deaths due to overdose.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/link-between-state-opioid-prescription-levels-and-information-seeking-behavior-towards-non-pharmacological-and-complementary-pain-interventions/