America is in the wake of an opioid crisis, yet 25 percent of adult patients who seek medical attention for a sprained ankle are given highly-addictive painkillers.

The suspicion that physicians continue to use narcotics for minor injuries was confirmed by a recent study from the University of Pennsylvania School of Medicine, called Annals of Emergency Medicine.

The state-by-state review showed a wide variation in the use of opioids for sprains, all but one of the nine states, which recorded above-average opioid prescribing habits, are located in the South or Southwest.

“Although opioids are not – and should not – be the first-line treatment for an ankle sprain, our study shows that opioid prescribing for these minor injuries is still too common and far too variable,” said lead author of the study, M. Kit Delgado MD, MS, an assistant professor of Emergency Medicine and Epidemiology at Penn.

The study examined private insurance claims data from more than 30,800 patients visiting U.S. emergency departments for an ankle sprain from 2011-2015. According to The Washington Post, the analysis revealed these prescription can highly influence long-term opioid use.

This study was conducted shortly before the CDC issued guidelines limiting doctors to use opioids sparingly, but provides the most recent information.

Opioid use and abuse has risen quickly in America, according to Stat News, deaths from opioids and drug overdoses kill more Americans under 50 than anything else, leading to nearly 100 deaths a day from the addictive painkillers. If the over-prescribing does not change, researchers predict that by 2027 the U.S. death toll from opioids may surpass the worst year of gun deaths on record, edging close to the worlds worst year of AIDS deaths.

On average, the prescription given to patients was 15 tablets, about a three day supply of hydrocodone, oxycodone or other narcotics. Patients receiving the largest amounts were five times as likely to continue with habitual, prolonged opioid use and abuse than those given a smaller dosage.

Although emergency room doctors are only responsible for a small portion of the vast amount of opioids consumed by patients each year, the percent who receive them is still high. According to the Centers for Disease Control and Prevention, almost 215 million prescriptions for the drugs were filled in 2016 alone.

Researchers say the narcotic-prescribing habits can be changed with some effort. An emergency department in New Jersey lowered opioid prescribing for common pain from 14 percent to two percent and urges other emergency departments to follow suit, potentially saving lives.

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