Medicare program: 'Extreme' opioid use, questionable prescribing habits

A new government report reveals “extreme” use of opioid painkillers by some Medicare patients and highlights doctors' questionable prescribing habits. And two other reports, including one from health insurer Cigna, shed light on why it's so hard for physicians to swim against the opioid tide. 

In a report (PDF) released yesterday, the U.S. Department of Health and Human Services' Office of Inspector General found one in three Medicare Part D beneficiaries received a prescription opioid in 2016, with about 500,000 of them receiving high amounts of these painkillers. The report found almost 90,000 were at “serious risk,” with some receiving extreme amounts of opioids while others appear to be “doctor shopping.”

The report found some patients are being prescribed opioids by 10 or more doctors, or are filling prescriptions for more than 1,000 pills a month—sobering statistics in light of the country’s opioid epidemic.

About 400 prescribers had questionable opioid prescribing patterns for patients at serious risk, the report said.

RELATED: Opioid crisis an urgent public health threat, but panel outlines steps that could curb epidemic

A new report (PDF) from Cigna, based on research from the Economist Intelligence Unit, echoes the crisis portrayed in the OIG report. A survey conducted in June and July found that of 304 medical and addiction practitioners, 99% said they have treated patients taking opioids or suffering from opioid addiction.

Of that number, 70% have treated military veterans. Of 2,800 Americans from all 50 states, 40% said they have experienced addiction themselves or have friends, family or co-workers with an addiction problem.

RELATED: A national crisis—CDC reports prescriptions for opioids have tripled since 1999

Meanwhile, a new study finds that most primary care physicians say there are substantial barriers to taking patients off of medications. The study, published in the Annals of Family Medicine, found that although most physicians surveyed agreed that deprescribing among older adults is important, there are barriers to doing that and little incentive to make changes.

Physicians described deprescribing as “swimming against the tide” of patient expectations, the medical culture of prescribing and organizational constraints, according to researchers from the University of Auckland in New Zealand.