Breaking News
April 25, 2019 - Vanderbilt investigators discover link between vascular biology and eye disease
April 25, 2019 - Feces transplantation is effective and provides economic benefits
April 25, 2019 - Eisenhower Health first in Southern California to offer new lung valve treatment for COPD/emphysema
April 25, 2019 - Johns Hopkins researchers uncover role of neurotransmitter in the spread of aggressive cancers
April 25, 2019 - Porvair Sciences offers highly effective P3 microplate for biological sample clean-up
April 25, 2019 - Air pollution increases risk for respiratory hospitalization among childhood cancer survivors
April 25, 2019 - We are sitting more! How bad is that?
April 25, 2019 - ADHD Screening: MedlinePlus Lab Test Information
April 25, 2019 - Cellular alterations increase vulnerability of obese and diabetic individuals to infection
April 25, 2019 - Association Insurance Pushes On Despite Court Ruling
April 25, 2019 - Traditional and e-cigarette users may be more receptive to smoking cessation interventions
April 25, 2019 - Delving into tumor’s cellular lineage may offer clues for customized therapies
April 25, 2019 - Two studies uncover brain mechanisms underlying decision making process
April 25, 2019 - Cardiometabolic Risk Better ID’d in Children Reclassified to Higher BP
April 25, 2019 - How the obesity epidemic is taking a toll on our bones and joints
April 25, 2019 - E-cigarettes contaminated with dangerous microbial toxins
April 25, 2019 - Researchers document specific characteristics of storefront tobacco advertisements
April 25, 2019 - Oncotype DX-guided treatment could reduce cost for breast cancer care, study suggests
April 25, 2019 - New review highlights how lifestyle affects our genes
April 25, 2019 - Study provides evidence that blood tests can detect Alzheimer’s risk
April 25, 2019 - Computer program mimics natural speech using brain signals from epilepsy patients
April 25, 2019 - Physicians turning to antibiotic alternatives for long-term acne treatment
April 25, 2019 - Preschool Is Prime Time to Teach Healthy Lifestyle Habits
April 25, 2019 - Study finds insidious and persistent discrimination among physician mothers
April 25, 2019 - Newly identified skin-gut communication helps illuminate link between food allergy and eczema
April 25, 2019 - Thiazide use linked with reduced risk of low energy fractures in people with Alzheimer’s
April 25, 2019 - Some women are biologically more resilient than others to PTSD
April 25, 2019 - The Current issue of “The view from here” is concerned with Partnerships and Alliances
April 25, 2019 - Imaging method reveals long-lived patterns in cells of the eye
April 25, 2019 - Podcast: KHN’s ‘What The Health?’ The Abortion Wars Rage On
April 25, 2019 - Prolonged exposure therapy is more effective in treating veterans with PTSD, alcohol use disorder
April 24, 2019 - Our artificial cornea breakthrough could lead to self-assembling organs
April 24, 2019 - A Stanford black, female, gay surgery resident speaks out
April 24, 2019 - Donna Lynne on Extreme Sports, Lessons From the '60s, and Taking CUIMC to the Next Level
April 24, 2019 - Pain Clinics’ Doctors Needlessly Tested Hundreds Of Urine Samples, Court Records Show
April 24, 2019 - Researchers uncover potential clue to halt destruction of nerve cells in people with ALS
April 24, 2019 - Study uncovers reasons for poor mental health in bisexual people
April 24, 2019 - Screenings, interventions, and referrals can help adolescents overcome substance abuse
April 24, 2019 - Febrile seizures following vaccination are self-resolving and not dangerous
April 24, 2019 - Flow-UV inline UV-Visible spectrometer monitors dispersion in real time
April 24, 2019 - Rates of Marijuana Use in Cancer Patients on the Rise in U.S.
April 24, 2019 - Versatile drug may protect baby from hazards of intraamniotic infections
April 24, 2019 - Financial transparency may diminish trust in doctors, new study finds
April 24, 2019 - Calling all Riders: Velocity Extends Free Registration 
April 24, 2019 - The Homeless Are Dying In Record Numbers On The Streets Of L.A.
April 24, 2019 - Researchers use brain scans to provide better understanding of unconscious bias
April 24, 2019 - Blocking BRAF ubiquitination may be an effective treatment approach in melanoma
April 24, 2019 - Simple mobility test helps predict hospital readmission in elderly heart attack patients
April 24, 2019 - Novel fluorescence imaging system helps surgeons remove small ovarian tumors
April 24, 2019 - Uncovering the Structure of HIV Integrase to Inform Drug Discovery
April 24, 2019 - Medical Marijuana Use Rising Among Cancer Patients
April 24, 2019 - Artificial intelligence approach optimizes embryo selection for IVF
April 24, 2019 - Doctor or detective? Sleuthing mysteries in medical school
April 24, 2019 - CUIMC Community Gives Blood During Spring 2019 Columbia University Blood Drive
April 24, 2019 - Americans Overwhelmingly Want Federal Protections Against Surprise Medical Bills
April 24, 2019 - Making Laboratories More Efficient with the Most Modern LIMS on the Market
April 24, 2019 - Treating cancer patients with personalized, combination therapies improves outcomes
April 24, 2019 - Researchers engineer new molecules to help stop lung cancer
April 24, 2019 - Acupuncture can be a wonderful tool for preventing number of diseases
April 24, 2019 - Daily life disability before hip replacement may predict poor post-operative outcomes
April 24, 2019 - Study finds involuntary staying in housing estates to be a potential health risk
April 24, 2019 - Older kidney disease patients starting dialysis die at higher rates than previously thought
April 24, 2019 - Time-restricted eating shows promise for controlling blood glucose levels
April 24, 2019 - Ambiguous genitalia in newborns may be more common than previously thought
April 24, 2019 - Research provides important insight on the brain-body connection
April 24, 2019 - In 10 Years, Half Of Middle-Income Elders Won’t Be Able To Afford Housing, Medical Care
April 24, 2019 - Researchers study how E. coli clones have become major cause of drug-resistant infections
April 24, 2019 - Bacterial and fungal toxins found in popular electronic cigarettes
April 24, 2019 - Factors affecting absorption of ‘sunshine vitamin’ during spring/summer months
April 24, 2019 - Texting helps improve medication adherence, health outcomes for patients with schizophrenia
April 24, 2019 - Cochrane Review looks at different ways to use nicotine replacement therapies
April 24, 2019 - New review on relationship between COPD and Type 2 diabetes
April 24, 2019 - Brain areas linked to memory and emotion aid odor navigation in humans
April 24, 2019 - Brain stimulation reverses age-related memory loss
April 24, 2019 - Amid Opioid Prescriber Crackdown, Health Officials Reach Out To Pain Patients
April 24, 2019 - $4 million NIH award will help establish UCI Skin Biology Resource-based Center
April 24, 2019 - Cancer drugs reprogram genes in breast tumors to prevent endocrine resistance, finds study
April 24, 2019 - Combination-imaging technique provides new window into macaque brain connections
April 24, 2019 - Researchers identify new allergen responsible for allergy to durum wheat
April 24, 2019 - Researchers define role of rare, influential cells in the bone marrow
‘No Documented Reason’ for 1 in 3 Outpatient Opioid Rxs: Study

‘No Documented Reason’ for 1 in 3 Outpatient Opioid Rxs: Study

image_pdfDownload PDFimage_print

MONDAY, Sept. 10, 2018 — The United States is in the grip of an epidemic of opioid painkiller addiction. But now, research shows that in nearly a third of cases there’s no medical reason documented for opioids prescribed in an outpatient setting.

The findings show the need for stricter rules on recording patients’ needs for the highly addictive drugs, the research team said.

When medical records fail to spell out the reason a patient got an opioid painkiller, this “undermines our efforts to understand physician prescribing patterns and curtails our ability to stem overprescribing,” study lead author Dr. Tisamarie Sherry said in a Harvard Medical School news release. She’s an instructor in medicine at Harvard and an associate physician at Brigham and Women’s Hospital in Boston.

One addiction specialist said real solutions to overprescribing are needed.

“Despite numerous policy changes, recent analyses suggest national opioid prescribing rates have not meaningfully decreased,” noted Dr. Harshal Kirane, who directs addiction services at Staten Island University Hospital in New York City.

Kirane described the rate of poorly documented prescribing seen in the study as “alarming,” suggesting that “lax prescribing practices remain widespread.”

There were more than 63,600 drug overdose deaths in the United States in 2016, according to the U.S. Centers for Disease Control and Prevention. About two-thirds involved an opioid. On average, 115 Americans die every day from an opioid overdose.

In the new study, Sherry’s group tracked data on opioid prescriptions given during nearly 809 million doctor’s office visits nationwide between 2006 and 2015.

Of those prescriptions, just over 5 percent were for cancer-related pain and 66.4 percent were for treating non-cancer pain.

For the other 28.5 percent, there was no record of pain or a pain-related condition, the researchers said.

Of the prescriptions for non-cancer pain, the most common conditions included back pain, diabetes and arthritis.

Of the prescriptions with no record of pain, the most common conditions were high blood pressure, high cholesterol and opioid addiction (2.2 percent).

Prescriptions with no record of pain were more common in visits where opioid prescriptions were being renewed (30.5 percent) than in visits that involved new prescriptions (22.7 percent), the study found.

The researchers said there’s been a sharp rise in opioid prescriptions in the past 20 years — an increase that exceeds actual rates of pain in the population. It’s possible that too often, opioids are being prescribed for conditions that don’t warrant treatment with the drugs, Sherry and colleagues said.

Dr. Robert Glatter is an emergency physician at Lenox Hill Hospital in New York City. He’s seen the ravages of opioid addiction firsthand, and believes many cases were avoidable.

When patients come to a doctor seeking pain relief, “we have to ask ourselves why we are prescribing an opioid in the first place?” Glatter said.

“Are there other alternatives that may work, but also help reduce risks for side effects, dependence, abuse or misuse?” he said.

And even if an initial prescription of an opioid was justified, that “does not automatically justify a refill of that medication for future and ongoing care,” Glatter said.

He said even though the paperwork might be time-consuming, it’s important for physicians to record their rationale for giving someone an opioid.

Non-opioid medications and other alternative approaches must be considered, Glatter said. All of this “requires creativity and taking time to ‘think outside the box,’ ” he said. “We owe it to our patients and their families.”

The study was published Sept. 10 in Annals of Internal Medicine.

More information

The U.S. National Institute on Drug Abuse has more about prescription opioids.

© 2018 HealthDay. All rights reserved.

Posted: September 2018

Tagged with:

About author

Related Articles