Opioid Overprescribing: Who is Responsible?
Opioids are prescribed by a broad cross-section of medical professionals, making overprescription the problem of all health professionals, not just a small subset, as previously suggested.
Past research has suggested that as much as 80% of opioids are prescribed by a very small subset of medical professionals.
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To examine this idea, researchers used data from individual prescribers from the 2013 Medicare Part D claims data set. This set covers approximately 68% of the 50 million people on Medicare.
For each prescriber, identified by their National Provider Identifier number, researchers had access to drugs prescribed, total number of claims, and total costs, as well as location and specialty of practice. The researchers narrowed their search to claims containing hydrocodone, oxycodone, fentanyl, morphine, methadone, hydromorphone, oxymorphone, meperidine, codeine, opium, or levorphanol.
Overall, they found that 57% of opioid prescriptions are filed by 10% of healthcare professionals, including doctors, nurse practitioners, physician assistants, and dentists. The results indicated that the patterns of opioid prescriptions follow those for other medications, including those that aren’t abused.
“Medicare opioid prescribing is distributed across many prescribers and is, if anything, less skewed than all drug prescribing,” they concluded.
“High-volume prescribers are not alone responsible for the high national volume of opioid prescriptions. Efforts to curtail national opioid overprescribing must address a broad swath of prescribers to be effective.”