The Impact of Inconsistent Prescribing Patterns on the Opioid Epidemic
As healthcare systems struggled with the onset of rapidly growing COVID-19 cases in 2020 and 2021, resources were shifted towards tackling the pandemic causing a reduction in access to other areas including behavioral health. Since the onset of the COVID-19 pandemic, overdoses have accelerated by 30% increasing the burden on the American healthcare system and trauma to those affected by opioid addiction.
According to the CDC1, the opioid crisis caused nearly 500,000 overdose deaths between 1999 and 2019. During the 1990s, there was an increased number of opioid prescriptions, leading to a rise in overdose deaths involving prescription opioids. Opioids are among the top prescribed medications in the United States and despite an overwhelming growth in popularity, opioid production and distribution remained unregulated.
Inconsistent Prescribing Patterns
Prescribing rates vary significantly from state to state and clinician to clinician, and these differences accelerated the crisis. Although the national opioid prescribing rate plateaued between 2010 and 2012, the number of opioids prescribed in morphine milligram equivalents (MME) per person is still about three times higher than it was in 1999, increasing the risk of patient overdose and death2. The research found that patients treated by doctors who prescribe opioids more often are at greater risk for long-term opioid use, which increases their risk of misuse, addiction, or overdose3, and as many as one in four long-term opioid therapy patients treated in a primary care setting experience opioid addiction4.
Prescribing Guidelines
In 2016, the CDC created recommendations to help primary care providers determine when to use opioids for chronic pain, how to manage dosage, duration, follow-up, and discontinuation as well as how to assess risk and address harm5. However, adherence is not widespread and remains inconsistent from clinician to clinician.
Rural communities are particularly impacted, as opioid prescribing patterns in rural counties are higher than the national average. One reason providers may prescribe more than the recommended guidelines is patient satisfaction. In 2019, 28% of overdose deaths involved prescription opioids, and on average, more than 38 Americans died each day from a prescription opioid overdose6.
In a recent white paper, we discuss the opioid crisis, an evidence-based approach to opioid management for chronic pain patients, and the benefits of improving long-term opioid therapy, to view it, please click here.
1 https://www.cdc.gov/opioids/data/analysis-resources.html
2 https://www.cdc.gov/drugoverdose/deaths/prescription/practices.html
3 https://www.hsph.harvard.edu/news/press-releases/opioids-addiction-physicians/
4 https://www.cdc.gov/opioids/basics/prescribed.html
5 https://www.cdc.gov/opioids/providers/prescribing/guideline.html