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Concurrent Opioid Prescribing by Multiple Providers Common, Linked to Increases in Hospital Admissions — Physician’s First Watch

Medical News |
February 21, 2014

Concurrent Opioid Prescribing by Multiple Providers Common, Linked to Increases in Hospital Admissions

By Amy Orciari Herman

Medicare beneficiaries frequently receive concurrent opioid prescriptions from multiple providers, placing them at increased risk for opioid-related hospitalization, a BMJ study finds

Researchers examined data on over 1.2 million Medicare beneficiaries who filled more than one prescription for an opioid in 2010. Overall, 39% filled opioid prescriptions from one provider, 35% from two, 14% from three, and 12% from four or more. Among those with opioid prescriptions from two providers, nearly a third received concurrent prescriptions from both providers; among those with prescriptions from four or more providers, over three quarters received concurrent prescriptions.

As the number of opioid prescribers increased for a particular patient, so did the likelihood of admission for an opioid-related concern.

The researchers stress the importance of educating patients about the risks associated with getting opioid prescriptions from more than one provider.

Reader Comments (2)

Jay Rosen MD Physician, Family Medicine/General Practice, New Jersey

If you are not closely monitoring your controlled substance patients, you shouldn't be prescribing. NJ has a wonderful program which captures every controlled substance RX and makes them available to enrolled providers. Every state should do the same for seamless monitoring.

ROGER FELIX Albuquerque

This is exactly why clinicians prescribing opioids, especially in settings such as urgent care where the patient is unfamiliar, need to have a very low threshold for using online state board of pharmacy controlled substance logs. The log for my state, New Mexico, has become extremely easy to use and much more accurate since the state pharmacy board went from a call-in service (an individual in the office would compile the patient's record manually and it could take minutes or hours) to a fully digital, up-to-date record comprising all controlled prescription meds from all pharmacies, even out-of-state. Using the current service, login to data takes less than 30 seconds. As a result, I have caught dozens of doctor-shoppers, including a traveling opioid misuser who got prodigious quantities of opioids from multiple physicians in another state. I once had a patient leave an urgent care clinic after seeing the stack of her (multiple prescriber, vast quantities of opioids) data, bearing the state seal, in my hand . She said something like, "I can see from what you're holding there that I'm not going to get what I want," and walked out without another word.

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