EHR data shows drop in opioid prescribing by doctors

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As the opioid crisis reaches epidemic proportions, new data show that physicians are prescribing opioids to fewer patients, and they are also being stingy when it comes to prescribing drugs to treat opioid dependence.

Athenahealth, a cloud-based electronic health record vendor, analyzed data from more than 2 million patient visits from the first quarter of 2014 to the first quarter of 2017.

While prescription opioid misuse has emerged as an urgent public health crisis, what researchers found is that opioid prescriptions have been steadily declining over that time period.

“We’ve seen doctor prescribing patterns decreasing,” says Josh Gray, vice president of athenaResearch. “It’s been particularly notable, for example, that orthopedic surgeons and primary care physicians have seen reductions.”

Based on the data, both orthopedic surgeons and primary care physicians are prescribing opioids to fewer patients.

At the same time, Gray notes that more patients have opioid addictions but there has only been a slight increase in providers prescribing drugs to treat opioid dependence, which he sees as a troubling development.

“If you’re a doctor and you’re reducing the frequency with which you give patients opioids, some of those patients might be dependent,” observes Gray. “You’d like to think that at least the healthcare system would be offering medication-assisted treatment to patients that are dealing with dependence or active addiction.”

He adds that the proportion of doctors in athenaResearch’s dataset that prescribe buprenorphine, a medication that reduces or eliminates withdrawal symptoms associated with opioid dependence, has “barely nudged up” which Gray describes as a “terrible” trend.

“Doctors are being much more parsimonious in terms of prescribing opioids, but the accessibility to medication-assisted treatment—like buprenorphine and similar pharmaceutical compounds—isn’t increasing,” according to Gray. “I’m not a physician, but that may be one of the reasons we’re seeing continued extremely high levels, if not increases, in overdose deaths. It’s not that hard to procure opioids illegally. So, patients who are dependent that can’t get medication to treat their dependence then go to other sources that aren’t medically supervised, which is incredibly dangerous.”

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Since 2000, more than 300,000 Americans have lost their lives to an overdose from either prescription or illicit opioids, according to the Centers for Disease Control and Prevention. The CDC has been working to improve opioid prescribing to reduce unnecessary exposure to opioids and prevent addiction.

In December 2016, President Obama signed the 21st Century Cures Act which provides $1 billion in new funding to combat the opioid crisis. Last week, Health and Human Services Secretary Tom Price, MD, announced that HHS will soon provide $485 million in grants to help states and territories target opioid addiction—the first of two rounds provided for in the Cures Act.

HHS has prioritized five specific areas: strengthening public health surveillance, advancing the practice of pain management, improving access to treatment and recovery services, targeting availability and distribution of overdose-reversing drugs, and supporting cutting-edge research.

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