HCPLive Network

'Doctor Shoppers' Account for Less Than 2 Percent of All Opioid Prescriptions

THURSDAY, July 18 (HealthDay News) -- A small proportion of opioid prescription purchasers (0.7 percent) obtain an average of 32 prescriptions from 10 different prescribers, accounting for 1.9 percent of all opioid prescriptions, according to a study published online July 17 in PLOS ONE.

Douglas C. McDonald, PhD, and Kenneth E. Carlson, from Abt Associates Inc. in Cambridge, MA, examined the prevalence of doctor shopping to obtain multiple opioid prescriptions and the amounts and types of opioids involved. Records were reviewed for 146.1 million opioid prescriptions dispensed by 76 percent of U.S. retail pharmacies during 2008. Prescriptions were linked to unique patients.

The researchers found that patients in the extreme outlying population (0.7 percent of purchasers), who were thought to be doctor shoppers, obtained 32 prescriptions for opioids from 10 different prescribers, on average. This group purchased 1.9 percent of all opioid prescriptions, constituting 4 percent of the total weighed amounts that were dispensed.

"To close the information gap that makes doctor shopping and uncoordinated care possible, states have created prescription drug monitoring programs to collect records of scheduled drugs dispensed, but the majority of physicians do not access this information," the authors write. "To facilitate use by busy practitioners, most monitoring programs should improve access and response time, scan prescription data to flag suspicious purchasing patterns, and alert physicians and pharmacists."

The authors are employees of Abt Associates Inc., a commercial scientific research company.

Full Text

Copyright © 2013 HealthDay. All rights reserved.

Further Reading
The Canadian government’s recent decision to allow the sale of a generic version of the original formulation of OxyContin could have serious consequences for efforts to curb opioid abuse, misuse, and diversion in the US.
The push to provide better pain care and ensure adequate analgesia for patients living with chronic pain led to liberalized opioid prescription practices that have been accompanied by a massive increase in the abuse, misuse, and diversion of prescription opioids. Efforts to combat this include technological remedies such as “abuse-deterrent” formulations of opioids and educational approaches such as the REMS program approved by the FDA in 2012.
Emergency providers are fairly accurate at identifying drug-seeking behavior, demonstrating fair agreement with prescription drug monitoring program criteria.
There is a strong correlation between increasing adult drug prescriptions and exposure and poisoning among children, particularly those aged 0 to 5 years.
While the peak of the opioid epidemic may now have been reached (according to some), we are not out of the woods. Every decision to start or continue opioid therapy must be careful, deliberate, and weigh benefit against risk, while keeping in mind that risk is not constant/static, but dynamic and evolves through time.
Will the approval of Zohydro benefit patients and physicians by providing another option for pain relief for patients with legitimate chronic pain needs, or will it spark a new wave of abuse, misuse, and diversion?
Noting that it takes an average of 5 years before a fibromyalgia patient receives a diagnosis, researchers conducted a retrospective data analysis to identify significant variables that may enable earlier detection and diagnosis of fibromyalgia.
More Reading