Study: Nearly One-Third Of All Opioid Scripts Are Prescribed Without A Stated Medical Reason

Steve Birr | Vice Reporter

Over the past decade, American doctors failed to provide a written medical justification for nearly one-third of opioid prescriptions, a report finds.

Researchers from RAND Corporation and Harvard Medical School published a study Tuesday in the journal Annals of Internal Medicine showing 28.5 percent of the roughly 809 million doctor visits that resulted in a prescription for opioid painkillers between 2006 and 2015 lacked medical records showing a chronic pain condition or any symptoms of pain related to the patient, reports CNN.

Roughly 5.1 percent of opioid prescriptions were written for cancer patients suffering from breakthrough pain, while 66.4 percent were for patients with non-cancer related pain. Researchers note that while a lack of documented justification does not necessarily reveal “a nefarious purpose on the part of the doctor,” it might explain in part how Americans became so dependent on opioids. (RELATED: CDC Warns Of ‘Dramatic Rise’ In Synthetic Opioid Deaths Over 2017)

“For these visits, it is unclear why a physician chose to prescribe an opioid or whether opioid therapy is justified,” said Dr. Tisamarie B. Sherry, a researcher for RAND Corporation and lead author of the study, according to CNN. “The reasons for this could be truly inappropriate prescribing of opioids or merely lax documentation. … If a doctor does not document a medical reason for prescribing an opioid, it could mean that the prescription is not clinically appropriate.”

Drug overdoses, fueled by the opioid crisis, are the leading cause of accidental death for Americans under age 50, killing more than 64,000 people in 2016, according to the CDC. Officials say preliminary data shows drug overdoses killed roughly 72,000 people across the U.S. in 2017.

Prescription opioids still accounted for more than 40 percent of opioid-linked deaths in 2016, killing roughly 46 people each day. The annual number of prescriptions for opioid painkillers has largely remained static since 2007 despite record high overdose deaths and increased dosages.

A study published Aug. 1 in medical journal The BMJ reveals that between 2007 and 2016, the percentage of commercially insured patients prescribed opioids held steady at 14 percent.

The study, lead by Molly Moore Jeffery of the Mayo Clinic in Rochester, Minnesota, investigated the individual patient data of 48 million people with health insurance, both commercial and through Medicare. The prescription data was then converted into milligram morphine equivalents (MME). They found the average MME dosage across all patients reviewed in the study was higher in 2016 than in 2007, a level Jeffery said is a “point where you see a greater risk of overdose.”

The researchers advocate for a general shift within the medical community away from opioids, however, Jeffery does not advocate legislative solutions that end up impacting patient access to crucial medication.

Data released by officials with the CDC on July 11 shows the majority of opioid-linked deaths are the result of synthetic opioids like fentanyl.

The report shows synthetic opioids killed roughly 27,000 people across the U.S. over the 12-month period ending November 2017, up from roughly 19,413 lives in 2016 and 9,580 lives in 2015.

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