More evidence elucidating patterns of opioid use has been recently published in the United States. Specifically investigating the distribution and patterns of opioid prescribing, this retrospective, observational study includes data from 669,495 providers, 8.9 million opioid prescriptions and 3.9 million patients between 2003 and 2017. Researchers reported disproportionate usage characteristics: 1% of providers prescribed 49% of all opioid doses and 27% of all opioid prescriptions, a pattern which has remained consistent since 2008. The same providers also exceeded the 2016 CDC chronic pain prescribing guidelines, with many prescriptions involving more than 50 morphine milligram equivalents (MMEs) per day and for longer than seven days. Despite this, it was found that the remaining 99% of providers generally prescribed within guidelines, with a majority of prescriptions involving less than 50 MMEs per day for less than seven days. Based on these findings, the researchers propose that interventions directed at prescribing by frequent opioid providers (such as improving patient care and minimizing comorbidities), will be more likely to be more effective than further restricting opioid prescribing for all providers. The original report, published in the BMJ, can be viewed here.
Contributed by Australian Medication Safety Services Associate – Isabella Singh