Opioid crisis not limited to a few bad apples

Beth Duff-Brown

Most prescriptions for opioid painkillers are made by the broad swath of U.S. general practitioners, not by a limited group of specialists, according to a study by researchers at the Stanford University School of Medicine.

This finding contrasts with previous studies by others that indicated the U.S. opioid epidemic is stoked by a small population of prolific prescribers operating out of corrupt “pill mills.”

The study, which examined Medicare prescription drug claims data for 2013, appears in a research letter published today in JAMA Internal Medicine.

“The bulk of opioid prescriptions are distributed by the large population of general practitioners,” said lead author Jonathan Chen, a Stanford Health Policy VA Medical Informatics Fellow.

The researchers found that the top 10 percent of opioid prescribers account for 57 percent of opioid prescriptions. This prescribing pattern is comparable to that found in the Medicare data for prescribers of all drugs: The top 10 percent of all drug prescribers account for 63 percent of all drug prescriptions.

“These findings indicate law enforcement efforts to shut down pill-mill prescribers are insufficient to address the widespread overprescribing of opioids,” Chen said. “Efforts to curtail national opioid overprescribing must address a broad swath of prescribers to be effective.”