Just 1% of all U.S. physicians prescribed half of all the doses of opioids and about a quarter of all opioid prescriptions in 2017, Healio reports.
Keith Humphreys, PhD, a professor of psychiatry and behavioral sciences at Stanford School of Medicine, led the research team that analyzed 2003 to 2017 prescription claims data from a large national insurance provider that covers 60 million people across the country. The study population’s demographics were very similar to the U.S. population as a whole in terms of age and sex.
Publishing their findings in BMJ, the study authors found that during the study period, 669,494 clinicians prescribed 8.2 billion morphine milligram equivalents (MMEs) to 3.9 million people.
In 2017, the top 1% of MME prescribers prescribed 49% of opioid doses and 27% of opioid prescriptions—figures that remained relatively steady after 2008. This finding held after the study authors controlled for the duration of prescriptions, the number of patients per health care provider and the number of prescriptions per provider.
The top 1% of opioid prescribers prescribed an average of 748,000 MMEs in 2017, a figure that was nearly 1,000 greater than the amount prescribed by clinicians at the median.
Centers for Disease Control and Prevention (CDC) guidelines recommend that prescriptions for opioids not exceed 50 MMEs per day and not last longer than seven days. Nevertheless, each year in the study period, 42% to 49% of the prescriptions from the top 1% of prescribers exceeded the CDC’s dose recommendation threshold, and 81% to 98% exceeded the duration recommendation. In the bottom 99% of prescribers, a respective 86% and 71% of prescriptions met these guidelines.
In the top 1% of prescribers, 24% were in family medicine, 14% were in physical or pain medicine and rehabilitation, 14% were anesthesiologists and 13% were internists.
To read the Healio article, click here.
To read the study, click here.