4.3 million opioid prescriptions go to “doctor shoppers”

NEWS IN BRIEF — Posted July 29, 2013

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Just one in every 143 opioid prescriptions goes to a patient whose pharmacy records suggest activity often characterized as “doctor shopping,” but these patients obtain a highly disproportionate share of opioids, according to a study published July 17 in the journal PLoS ONE.

Researchers said patients who received unusually large quantities of opioids from multiple physicians — an average of 32 prescriptions from 10 doctors — accounted for 4.3 million of the opioid prescriptions dispensed in the U.S. in 2008. By weight, that was equivalent to about 4% of all opioids, even though these patients were just 0.7% of the people who purchased 146 million opioids dispensed at retail pharmacies, said the study (link).

What is unclear is the extent to which doctor-shopping patients contribute to opioid-related overdoses and deaths. About 17,000 patients each year die of drug overdoses in which opioids are implicated, according to the Centers for Disease Control and Prevention.

Forty-six states have some form of prescription-drug monitoring program in place, though they vary widely in how easy they are for physicians to use and how often the records are updated. Timelier prescription information is key to enabling physicians to better detect patients intent on misusing or diverting narcotic painkillers, said Douglas C. McDonald, PhD, lead author of the PLoS ONE study.

“Physicians and other health care providers are the front lines of defense against deceptive patients who use these drugs for nonmedical purposes, but many of them lack the time and the tools to determine if a patient is abusing opioids,” McDonald said.

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