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New Study Shines Light on Opioid Prescribers

study shows most opioids written by small number of providersA study of the opioid prescriptions written by almost 700,000 medical care providers shows that nearly half of the doses written in the United States originate from just 1% of those providers. The study, as reported by Reuters, shows that this top 1% writes approximately 1,000 times more opioid doses than those making up the middle percentiles.

The results have taken the authors by surprise. “We did not know that opioid prescribing was so extraordinarily concentrated in the U.S., well beyond what we see for other medications,” says Keith Humphreys of Stanford University.

The study did not take into account any clinical reasons that the prescriptions might have been written. As a result, those doctors with specializations where pain management is a core aspect of their duties would obviously show numbers well outside the mean of the rest of the group. However, in a rather surprising twist, family medicine practitioners were the most common specialty in the cohort. It is not difficult to surmise then that some of those prescriptions might not have been entirely necessary and that a less powerful medication could have been used instead.

The lack of clinical data also means that it is impossible to assess situations where an opioid may have been appropriate or warranted but was not given out of provider concern for over-prescription. Prescriptions are ultimately at the discretion of those who have the authority to write them and one provider’s reasoning for writing an opioid in one situation may vary greatly from another provider’s reasoning for not writing an opioid in a similar situation.

As the capabilities of big data grow and we increase our ability to collect and analyze the data from hundreds of millions of datapoints at a time, it may become easier to monitor prolific opioid prescription writers and cut down on so-called pill mills. However, until we can factor in the reasoning behind each opioid dose for a given patient, we continue to leave a dangerous flank open in our fight to take back our communities.