The inappropriate prescription of opioids might have greatly contributed to the worsening opioid crisis in the United States, a recent study suggests.
Researchers looked at data from 2006-2015 to identify the most common conditions associated with an opioid prescription in ambulatory care. Instead, they found something alarming: some physician — 29 percent of them — did not provide a medical explanation for writing an opioid prescription.
Prescription Opioid And The Overdose Epidemic
A prescription opioid is a common medication used for severe pain and administered to patients following surgery or while undergoing treatment for cancer. The drug, albeit legal, poses serious risks for abuse, dependence, and overdose.
Once a patient is addicted, it becomes difficult to stop. A person who has overdosed on prescription opioid might stop breathing and die.
According to the Center for Disease Control and Prevention, in 2016 alone, 11.5 million people in the United States admitted to misusing prescription opioid. Since 1999, over 630,000 have died from an overdose.
Clinics Might Have Contributed To The Problem
A study published on Monday, Sept. 10, in the journal Annals of Internal Medicine looked at data from the National Ambulatory Medical Care Survey or NAMCS during the buildup to the current opioid crisis. The NAMCS, a cross-section survey of patients' visit to physicians, report details from the meeting including prescribed medication.
From their report, opioids were prescribed by physicians in 31,943 visits from 2006-2015. Only 5.1 percent of the total number of prescriptions were given to patients diagnosed with pain related to cancer.
A whopping 66.4 percent of the patients who were prescribed with opioid reported pain not associated with cancer. The remaining 28.5 percent had no pain diagnosis at all.
"For these visits, it is unclear why a physician chose to prescribe an opioid or whether opioid therapy is justified," explained Tisamarie B. Sherry, lead author of the study. "He reasons for this could be truly inappropriate prescribing of opioids or merely lax documentation."
The most common noncancer pain diagnoses of patients given opioid prescription are diabetes, osteoarthrosis, back pain, and other chronic pain. Those who experienced no pain but were given prescription opioids reported hypertension, hyperlipidemia, opioid dependence, and other follow-up examination.
Sherry said that there are many reasons why a clinic might not document their reason for writing opioid prescriptions. It is also possible that the prescription was "not clinically appropriate."
However, she clarified that the study does not mean that all transactions not backed with records were because of "nefarious purpose on the part of the doctor."
Solving The Opioid Crisis
Public health officials have advised doctors across the country to only prescribe opioids to patients when absolutely necessary and with the lowest dose possible. Since last year, more physicians have been cutting back from prescribing opioids, especially to patients who are not diagnosed with acute pain.