Opioid over-prescription not limited to a few physicians

Accreditation Insider, December 21, 2015

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Prescription opioid sales have increased 300% since 1999 according to the Centers for Disease Control and Prevention (CDC), with nearly 2 million Americans either addicted or dependent on them.

A common belief is that it’s a small number of people excessively prescribing opioids who are driving the trend; either due to carelessness, corruption or inexperience.  That said, a new report published in The Journal of the American Medical Association finds that rather than a few people writing many prescriptions, the increase is due to many prescribers writing small to moderate amounts.

Researchers compared opioid prescription rates amongst several medical specialties and found that the majority of prescriptions are being written by internal medicine practitioners, family physicians, and nurse practitioners.

A single family practitioner will write about 160 opioid prescriptions annually, an internal medicine physician writes 122, and a nurse practitioner writes 55, according to the report. By comparison, a single anesthesiologist will write 484 prescriptions a year and an interventional pain management (IPM) specialist will write 1,125.

However, the number of people working in internal medicine, family medicine and nurse practitioners vastly outweighs other opioid-prescribing specialties. Researchers found that as a group, family physicians accounted for 15.3 million opioid prescriptions annually, internal medicine physicians wrote 12.8 million, and nurse practitioners prescribed 4.1 million. Meanwhile, both IPM specialists and anesthesiologists write roughly 2 million opioid prescriptions apiece.

In response to the rise in opioid addiction in the U.S. the CDC released a draft of opioid prescription guidelines for public comment. However, there was such an outcry over the guidelines, which focused on using non-pharmacologic and non-opioid therapies for chronic pain patients, that they’ve been postponed.

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