'No documented reason' for one-third of outpatient opioid prescriptions

'No documented reason' for one-third of outpatient opioid prescriptions

Photo of medical records.

The Harvard-Rand researchers believe the crisis may be partly fueled by inappropriate prescription practices for conditions that do not warrant treatment with opioids.

However, there was wide variation across states, threefold between the low vs. high prescribing states, and at the extremes it was over tenfold, with only 3 percent of patients received an opioid prescription in North Dakota, compared to 40 percent in Arkansas.

Researchers analyzed data for more than 800 million opioid prescriptions over a 10-year period.

A close check of medical records from 2006 to 2015 showed that a physician gave no explanation at all for writing an opioid prescription in 29 percent of the cases, the team at Harvard Medical School and the Rand Corp. found.

But now, research shows that in almost a third of cases there's no medical reason documented for opioids prescribed in an outpatient setting. The drug, albeit legal, poses serious risks for abuse, dependence, and overdose.

Once a patient is addicted, it becomes hard to stop.

The CDC estimated back in August a record number of people died from drug overdoses in 2017.

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According to the National Institute of Drug Abuse, more than 115 people die each day in the USA after overdosing on opioids. Since 1999, over 630,000 have died from an overdose.

The study was published September 10 in Annals of Internal Medicine. The NAMCS, a cross-section survey of patients' visit to physicians, report details from the meeting including prescribed medication.

In total, opioids were given in nearly 809 million outpatient visits. The other five percent treated cancer-related pain.

Of the prescriptions and not utilizing a narrative of disaster, the most abnormal conditions had been excessive blood stress, excessive cholesterol and opioid dependancy (2.2 %). The remaining 28.5 percent had no pain diagnosis at all. She's an instructor in medicine at Harvard and an associate physician at Brigham and Women's Hospital in Boston. That finding, the researchers say, highlights the need for periodic reassessment of the medical need to refill an opioid prescription.The researchers say their results underscore the need for stricter requirements on documenting the need for opioids-;an approach many insurance providers already use to determine approval of new, costly drugs.

Of the prescriptions for non-cancer pain, the most common conditions included back pain, diabetes and arthritis. Those who experienced no pain but were given prescription opioids reported hypertension, hyperlipidemia, opioid dependence, and other follow-up examination. There was not enough information to make that judgment, Sherry said.In many cases, physicians prescribed opioids without a clear understanding of how addictive those medications were. It is also possible that the prescription was "not clinically appropriate".

However, she clarified that the study does not mean that all transactions not backed with records were because of "nefarious goal on the part of the doctor".

Previous year the U.S. Department of Health and Human Services declared a public health emergency after discovering that 2.1 million people had an opioid disorder in 2016.

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