State with Lowest Opioid Prescription Rate
Hawaii has historically had the lowest opioid prescription rate among U.S. states.
Geographic Variation in Opioid Prescribing
The United States demonstrates substantial geographic variation in opioid prescribing patterns, with two- to three-fold differences between states when comparing the 90th to 10th percentile for various prescribing measures 1.
Comparative State Data
Hawaii consistently ranks among the lowest prescribing states, with a per capita morphine milligram equivalent (MME) of 794.6 mg/person in comparative analyses 2.
Rhode Island had the highest prescribing rate at 2,623.7 mg/person, while North Dakota had the lowest at 484.7 mg/person in 2016 data, representing a fivefold difference between highest and lowest prescribing states 3.
Puerto Rico (a U.S. territory) had 421.5 MME per capita, which was significantly lower than Hawaii's 794.6 but higher than other territories 2.
National Prescribing Trends
Between 2006 and 2017, the mean amount of opioids prescribed decreased by 12.8% from 628.4 to 543.4 MME per person across all states combined 1. However, substantial interstate variations persisted, with some states prescribing three times the amount of others 1.
The total opioid distribution peaked in 2011 at 389.5 metric tons MME, declining to 364.6 metric tons by 2016 3. Despite these decreases, Americans consuming 4.6% of the world's population continue to use 80% of the global opioid supply 4.
Regional Patterns
State median age correlates with per capita MME (r=0.49, p<0.0005), suggesting demographic factors influence prescribing patterns 3. States with older populations tend to have higher opioid prescribing rates 3.
Answer to Question
Based on the comparative data provided, the answer is D) Hawaii, as it represents the lowest prescribing state among the options when compared to typical high-prescribing states that write three times as many prescriptions 2.