Background: Approximately 71 people die every day from a prescription drug-related overdose. Obtaining medications from a physician at the time of a visit, while convenient, can call into question quality of care, conflict of interest, and potential for abuse. The amount of opioids sold to physicians that dispense from their offices has not been described. Methods: DEA's Automation of Reports and Consolidated Orders System tallies controlled substances distributed to pharmacies, hospitals, and practitioners. Analyses of 1999-2013 data examined opioid analgesics distributed to dispensing practitioners. Drugs included: fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone; grams were converted to morphine milligram equivalents (MME). Results: Patterns of opioid distribution to practitioners varied markedly by state and over time. Comparing 1999- and 013, Hawaii had the highest percent change (514%; .07 to .44 MME 100,000/persons) and opioid distribution increased in 36 states. During the study period, however, FL changed notably (peak 8.94MME 100,000/persons in 2010; low of .07MME in 2012). The number of practitioners receiving distributions per state varied (2013 range: VT=1, CA=232; peak was FL=586 in 2010). Practitioner distribution as a percentage of all opioids distributed also varied. Conclusions: In mid-2011, Florida banned physicians from dispensing Schedule II and III opioids and it appears to have had the greatest shift in distribution. Other states, however, saw increases that may indicate a need to monitor the practice of physician dispensing. Controlled substance data can identify high prescribers and dispensers of opioids and examining overall state trends can inform responses to potentially abusive practices.