Family physicians unwittingly drive use of opioids

By Aine Cryts

It's not just a small number of rogue doctors prescribing a majority of the opioids in this country. Contrary to previously held research, most opioids are prescribed by family doctors and general practitioners, according to a research letter published in JAMA Internal Medicine.

Researchers studied prescriptions written by 808,020 physicians reimbursed by Medicare in 2013. Family physicians wrote 15 million prescriptions and internal medicine physicians wrote nearly 13 million, according to the data. Combined, these add up to more than half of all opioid prescriptions written that year.

Individually, pain management specialists each wrote around 900 to 1,100 prescriptions, while anesthesiologists each wrote nearly 500. Family physicians, who are much more numerous than specialists, each wrote about 160 prescriptions during the same timeframe.

"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,'" Jonathan Chen, M.D., an internist at Stanford School of Medicine and lead author of the research note, told Kaiser Health News. "Maybe all of us are contributing to this problem, even if we don't realize it."

More than 2 million people in the United States struggled with prescription opioid addiction in 2013, and more than 16,000 people died as a result of opioid overdose. In a study of 293 patients, one-quarter of the patients prescribed opioid painkillers on a short-term basis continued to use them for longer than 90 days, as previously reported by FiercePracticeManagement.

In related news, the U.S. Centers for Disease Control and Prevention issued new guidelines that advise primary care physicians to keep tabs on opioid use among their patients and to limit prescriptions as a way of stemming the opioid addiction crisis facing the country, reported STAT.

To learn more:
- read the research letter in JAMA Internal Medicine
- check out KHN  story
- view the STAT story

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