It’s not all doctors who over-prescribe opioids

I wrote a blog while ago about the over-prescribing of antibiotics in the state of Tennessee (although this is probably true everywhere) showing that just a few doctors account for the vast-over prescribing of antibiotics in that state, so if we want to cut back on doctors’ prescribing antibiotics uselessly, we need to focus our efforts on getting that small minority of doctors on board with existing guidelines.

Now another study, this one published in The BMJ Today, finds something similar about the prescription of opioids in the US, which has become, of course, a matter of urgent attention because of the epidemic of opioid abuse in that country (and elsewhere).

This study concluded that 1 % of all US “opioid providers” (in English, doctors who do prescribe opioids) account for just under half of all “opioid doses” in that country.

To be more precise, that 1 % of opioid-prescribers prescribe 49 % of all opioid doses and issue 27 % all opioid prescriptions, so this overall small number of docs don’t only prescribe the heaviest opioid doses, they also prescribe the heaviest opioid doses for the longest periods of time.

Or looking at it from the other side, these researchers conclude that 99 % of doctors actually prescribe opioids within acceptable guidelines, in proper doses for proper lengths of time.

In defense of some of the aforementioned 1 %, I have to point out that that would include some docs who see those people with the greatest amount of pain (although I think it can be questioned if heavy doses of opioids really are a good way to try to mitigate severe long-term pain).

But that 1 % must surely also include a number of doctors who are still handing out way too many too-strong meds to a clientele prone to problems with those drugs.

The best way to cut down the number of opioid pills out there, these researchers conclude, is not to ban the overall use of opioids but rather to focus re-education efforts on the prescribing patterns of that 1 %.