Specialty of Prescribers Associated with Prescription Opioid Fatalities in Utah, 2002–2010
- 1 January 2014
- journal article
- Published by Oxford University Press (OUP) in Pain Medicine
- Vol. 15 (1), 73-78
- https://doi.org/10.1111/pme.12247
Abstract
Opioid adverse events are widespread, and deaths have been directly attributed to opioids prescribed by medical professionals. Little information exists on the amount of opioids various medical specialties prescribe and the opioid fatality rate that would be expected if prescription opioid-related deaths were independent of medical specialty. To compute the incidence of prescription opioid fatalities by medical specialty in Utah and to calculate the attributable risk (AR) of opioid fatality by medical specialty. Prevalence database study design linking the Utah Controlled Substance Database (CSD) for prescribing data with the Utah Medical Examiner data to identify prescription opioid fatalities. AR were calculated for each medical specialty and year. Opioid prescriptions are common with 23,302,892 recorded in the CSD for 2002-2010, 0.64% of which were associated with a fatality. We attached specialty to 90.2% of opioid prescriptions. Family medicine and internal medicine physicians wrote the largest proportion of prescriptions (24.1% and 10.8%) and were associated with the greatest number of prescription opioid fatalities. The number of active prescriptions at time of death decreased each year. The AR of fatality by provider specialty varied each year with some specialties, such as pain medicine and anesthesiology, consistently associated with more fatalities per 1,000 opioid prescriptions than internal medicine physicians the same year. Primary care providers were the most frequent prescribers and the most often associated with opioid fatalities and should be targeted for education about safe prescribing along with specialties that prescribe less frequently but are associated with a positive AR for opioid fatality.Keywords
This publication has 10 references indexed in Scilit:
- Long-term opioid therapy, aberrant behaviors, and substance misuse: Comparison of patients treated by resident and attending physicians in a general medical clinicJournal of Opioid Management, 2012
- Ending Unnecessary Opioid-Related Deaths: A National PriorityPain Medicine, 2011
- Studying Adverse Events Related to Prescription Opioids: The Utah ExperiencePain Medicine, 2011
- State-Level Strategies for Reducing Prescription Drug Overdose Deaths: Utah's Prescription Safety ProgramPain Medicine, 2011
- Utah Clinical Guidelines on Prescribing Opioids for Treatment of PainJournal of Pain & Palliative Care Pharmacotherapy, 2010
- Impact of Physician and Patient Gender on Pain Management in the Emergency Department—A Multicenter StudyPain Medicine, 2009
- Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer PainThe Journal of Pain, 2009
- Disparities in Analgesia and Opioid Prescribing Practices for Patients With Musculoskeletal Pain in the Emergency DepartmentJournal of Emergency Nursing, 2006
- Changing Attitudes About Pain and Pain Control in Emergency MedicineEmergency Medicine Clinics of North America, 2005
- Model Policy for the Use of Controlled Substances for the Treatment of PainJournal of Pain & Palliative Care Pharmacotherapy, 2005