Doctors Prescribing Fewer Opioids for Pain

Nine out of 10 primary care doctors say that prescription drug abuse is a problem in their communities, and nearly half say they are less likely to prescribe opioids for pain than they were a year ago, according to a new study by Johns Hopkins Bloomberg School of Public Health.

The findings, published in JAMA Internal Medicine, show that primary care physicians appear to recognize many of the risks associated with prescription opioid use, including addiction and death by overdose.

“Our findings suggest that primary care providers have become aware of the scope of the prescription opioid crisis and are responding in ways that are important, including reducing their overreliance on these medicines,” said study leader G. Caleb Alexander, M.D., M.S., an associate professor of epidemiology at the School of Public Health and co-director of Johns Hopkins’ Center for Drug Safety and Effectiveness.

“The health care community has long been part of the problem, and now they appear to be part of the solution to this complex epidemic.”

Prescription drug abuse was called the nation’s fastest growing drug problem in a report released by the White House a few years ago. According to the U.S. Centers for Disease Control and Prevention, drug overdose death rates in the United States have more than tripled since 1990 and have never been higher.

The clinical use of prescription opioids nearly doubled between 2000 and 2010. In 2010, more than 38,000 people died from drug overdoses of all kinds, with many of these deaths caused by prescription opioids.

Only in recent years has the medical community paid much attention to the mounting epidemic, the researchers say.

For the study, researchers sent surveys in February 2014 to a nationally representative sample of 1,000 U.S. internists, family physicians, and general practitioners; 58 percent responded. Among the findings:

  • 85 percent of the respondents say that opioids are overused in clinical practice;
  • Many reported they are “very” or “moderately” concerned about serious risks, such as addiction (55 percent reporting “very concerned”), death (48 percent), and motor vehicle crashes (44 percent) that may be associated with opioid abuse;
  • Many also reported they believe that drug-related physical problems, such as tolerance (62 percent) and physical dependence (56 percent), occur “often,” even when the medications are used as directed for chronic pain.

Nearly all surveyed physicians (88 percent), however, expressed confidence in their own ability to prescribe opioids appropriately. Previous studies have found that most doctors believe their colleagues’ prescribing decisions are swayed by pharmaceutical marketing and promotion, but feel that they themselves don’t fall or these tactics.

Finally, Alexander hopes that more physicians and patients ultimately opt for non-opioid pain treatments and other non-drug treatments such as physical therapy, massage and acupuncture. He said future research with pharmacy data would help confirm that prescriptions for opioids are really decreasing.

Source: Johns Hopkins

Doctpr talking with patient about pain medication photo by shutterstock.