FRIDAY, March 15, 2019 — Many providers stopped initiating opioid therapy from July 2012 to December 2017, according to a report published in the March 14 issue of the New England Journal of Medicine.
Wenjia Zhu, Ph.D., from Harvard Medical School in Boston, and colleagues used administrative-claims data from across the United States to estimate the incidence of initial opioid prescriptions in each month between July 2012 and December 2017. Data were included for 63,817,512 enrollees who had not used opioids (no opioid prescription or a diagnosis of opioid use disorder in the six months before a given month).
The researchers observed a 54 percent decrease in the monthly incidence of initial opioid prescriptions among enrollees who had not used opioids, from 1.63 percent in July 2012 to 0.75 percent in December 2017. The reduction correlated with a declining number of providers who initiated opioid therapy in any patients who had not used opioids (from 114,043 in July 2012 to 80,462 in December 2017). Among the dwindling subgroup of physicians who initiated opioid therapy in patients who had not used opioids, high-risk prescribing (prescriptions for more than a three-day supply or for a dose of 50 morphine milligram equivalents per day or higher) persisted at a monthly rate of 115,378 prescriptions per 15,897,673 enrollees who had not used opioids.
“Understanding the clinical circumstances in which long-duration or high-dose opioid prescriptions are issued to patients who have not used opioids would help inform the design of opioid control policies that attempt to strike a balance between preserving access to pain control when needed and mitigating the risk of inappropriate use,” the authors write.
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Posted: March 2019