Doctors Gave No Reason For Writing Opioid Scripts In Nearly 30% Of Cases

By Maggie Ethridge 09/14/18

A new study uncovered that doctors were prescribing opioids for hypertension and high cholesterol when no pain diagnosis was recorded. 

doctor handing a prescription to a patient

A team at Harvard Medical School and the Rand Corp. combed through medical records from 2006 to 2015 and found that physicians gave no explanation for writing an opioid prescription in 29% of the cases.

According to NBC News, the Centers for Disease Control and Prevention (CDC) has been working to get doctors to pull back on opioid prescriptions, citing careless prescribing as one cause of the opioid crisis. In 2016, more than 42,000 people died of opioid overdose, according to the CDC.

The new study was led by Nicole Maestas, professor of health care policy at Harvard. Maestas and study coauthors went through tens of thousands of medical records, and then honed in on more than 31,000 physician surveys that included an opioid prescription.

In two-thirds of the prescriptions, some type of pain diagnosis was present.

The report, published in the Annals of Internal Medicine, then concluded, “No pain diagnosis was recorded at the remaining 28.5%.”

“At visits with no pain diagnosis recorded, the most common diagnoses were hypertension, hyperlipidemia (high cholesterol), opioid dependence and ‘other follow-up examination,'” the research revealed.

This over-prescribing could be unfairly impacting people who do have serious pain conditions and are finding it difficult to access the opioids they need to manage their pain due to new restrictions and doctors who fear that they will be targeted for over-prescribing.

Dr. Tisamarie Sherry, who worked on the study, was reported in NBC News as emphasizing, “Whatever the reasons, lack of robust documentation undermines our efforts to understand physician prescribing patterns and curtails our ability to stem overprescribing.”

The study also showed that 24% of youth who appeared with an opioid use disorder did not have a prescription to a medication-assisted treatment (MAT) drug to control their cravings.

Drugs like buprenorphine and methadone are approved by the Food and Drug Administration for the treatment of opioid use disorder.

“In this multistate study of addiction treatment and retention in care, we found that three-quarters of youths diagnosed with opioid use disorder received treatment within three months," researchers wrote in JAMA Pediatrics. "However, most treatment included behavioral health services only, and fewer than one of four youths received timely buprenorphine, naltrexone or methadone treatment."

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Maggie May Ethridge is the author of Atmospheric Disturbances: Scenes From a Marriage (Shebooks, 2014) and the recently completed novel, Agitate My Heart. She is a freelance writer published in Rolling Stone, VOX, Washington Post, The Guardian and many others. Find her at her blog Flux Capacitor or on LinkedIn or Twitter.