Some surgeons prescribed more than 10 times the recommended number of pills.
A recent study conducted by Kaiser Health News (KHN) and Johns Hopkins of 350,000 prescriptions for Medicare patients written by almost 20,000 surgeons from 2011 to 2016 for opioids to be taken the week after surgery revealed that, while the recommendation was typically zero to 10 pills (up to 30 for certain coronary surgeries), some surgeons prescribed more than 100, with little change in prescribing habits over the study period.
Manufacturers and distributors of opioids and their executives have been the targets of numerous lawsuits, but much less attention has been paid to the role that physicians may have played in causing the opioid epidemic, despite evidence to suggest that many people initially became addicted to opioids following their prescribed use after surgery.
The researchers say their data may be conservative, since most Medicare patients are older and surgeons are generally more cautious about the prescriptions they give to seniors. Arguments against the study focus on the fact that important factors were not taken into consideration that might lead to the need for higher prescriptions.
The researchers did note that in some cases prescriptions were determined by software with preset default amounts, often based on previous prescribing habits before issues with opioids were identified. They also point to the movement to consider pain as ‘the fifth vital sign’ and the push by pharma companies to make sure patients felt their pain was treated well by using opioids.
Newer data from 2017 and later will be evaluated once it is available to see whether prescribing habits changed once physicians became aware of the magnitude of the opioid crisis.