Study: ER patients of docs more likely to prescribe opioids have 30% greater chance of long-term use

Harvard graphic: Prescribing rates and adjusted
odds ratios for long-term opioid use.

Emergency room patients of doctors who are the biggest prescribers of opioids are 30 percent more likely to become long-term opioid users, says a study by researchers at Harvard T.H. Chan School of Public Health and Harvard Medical School published in the New England Journal of Medicine. Long-term users are defined as receiving six months’ worth of pills in the 12 months following the initial encounter.

ER patients prescribed opioids also are "more likely to have an adverse outcome related to the drugs, such as a fall, a fracture, respiratory failure, or constipation," reports Harvard. "The study also showed that patients treated by low-frequency prescribers were no more likely to return to the hospital overall or with the same complaints—findings that suggest these people were not under-treated for their symptoms."

The study consisted of 215,678 patients who received treatment from low-intensity prescribers and 161,951 patients who received treatment from high-intensity prescribers from 2008-11, based on Centers for Medicare and Medicaid Services data.

Doctors labeled as high-intensity prescribed opioids during 24.1 percent of patient visits, on average, while low-intensity only 7.3 percent of the time, Lenny Bernstein reports for The Washington Post. "Overprescribing by physicians has been widely blamed for helping to start an epidemic of prescription opioid abuse, which since 2000 has killed about 180,000 people through overdoses. But it has been difficult to apportion doctors' responsibility for the crisis or for policymakers to agree on measures to rein in their habits."