Opioid over-prescription not limited to a few physicians

Patient Safety Monitor Insider

December 23, 2015

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.

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.

This increase is due to more prescribers writing small to moderate amounts of opioid prescriptions, rather than a few prescribers writing an excessive amount of prescriptions as commonly thought, according to a report published in The Journal of the American Medical Association.

Researchers compared opioid prescription rates amongst several medical specialties and found that the majority of prescriptions are 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.

Earlier this month, 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 patients with chronic pain, the CDC postponed their release.