Researchers Call for Systemic Change To Address Opioid Rx Process
A systemic change to how health care providers prescribe certain medications is needed to address growing prescription drug misuse in the U.S., according to research published Monday in JAMA Internal Medicine, Kaiser Health News reports (Luthra, Kaiser Health News, 12/14).
The research comes as lawmakers seek to address a nationwide increase in painkiller misuse (Luthra, Kaiser Health News, 12/14).
The latest CDC data show 18,893 U.S. residents died from an overdose related to prescription opioid use, marking an increase of 16.3% from 2013. The rise in prescription drug misuse also correlates with an increase in heroin-related deaths (California Healthline, 12/14).
HHS earlier this year said it plans to devote an additional $100 million for community health centers in 11 states to address substance use disorders (Ferris, The Hill, 7/25). Meanwhile, the Obama administration earlier this year announced an initiative to combat heroin and prescription drug misuse throughout the U.S. (White House fact sheet, 10/21).
Research Highlights Need for Systemic Change
For the study, researchers analyzed 2013 Medicare claims to determine which physicians were prescribing opioid drugs, as well as how many prescriptions they filed for the drugs. According to the letter, the findings suggest that a majority of health care professionals are overprescribing opioids.
For example, the analysis found that instead of being concentrated among a small group of practitioners, opioid drugs are prescribed by a broad swath of medical providers, including:
- Nurse practitioners;
- Physicians; and
- Physician assistants.
The research found that 57% of painkiller prescriptions are filed by 10% of such providers. According to KHN, that figure is consistent with prescribing ratios for other types of prescription drugs. In general, 10% of physicians account for 63% of total prescriptions.
Study author Jonathan Chen said the findings suggest that more than just a few physicians are contributing to growing opioid use in the country. He noted, "Going after deviants, 'pill mills' or bogus pain clinics -- it feels good to do that, because you have a villain. You feel that if you get rid of them, the problem is solved, and what we're trying to say is, 'I don't think that's going to be enough.'"
Chen said public health initiatives aimed at prescription drug misuse must account for all physicians. He noted, "You need to address everyone, or at least a larger amount of prescribers than a few deviants" (Kaiser Health News, 12/14).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.