Brief ReportTrends in Opioid Analgesic–Prescribing Rates by Specialty, U.S., 2007–2012
Introduction
In the U.S., drug overdose deaths rose every year between 1999 and 2012,1 driven by prescription opioid analgesics.2 Primary care physicians prescribe the bulk of opioids.3 However, certain specialties, such as orthopedic surgery and dentistry, prescribe opioids at a higher rate than primary care physicians.4 Other medical specialties, such as emergency medicine, have documented large increases in opioid prescribing.5 There has not been a national comparison of the opioid-prescribing rates of the medical specialties over time. We used a recent commercial database to describe distributions and changes in opioid prescribing by medical specialty. We were interested in whether the recent emphasis on safe pain treatment had reduced opioid utilization among specialties with historically high or recently rising opioid-prescribing rates.
Section snippets
Methods
IMS Health’s National Prescription Audit (NPA) estimated the annual counts of all prescriptions dispensed nationally during 2007–2012. Prescriptions, including refills, dispensed at retail pharmacies, mail-order pharmacies, and long-term care facilities were included. The NPA sample included 67% of the approximately 57,000 pharmacies nationwide and captured nearly 80% of retail prescription dispensations in the U.S. NPA sampling methods are proprietary, and CIs for national estimates are not
Results
In 2012, U.S. pharmacies (retail and mail order) and long-term care facilities dispensed 4.2 billion prescriptions, 289 million (6.8%) of which were opioid analgesics. Nine specialty groups accounted for 70.5% of all prescriptions and 84.3% of opioid prescriptions (Table 1). Three primary care specialty groups (family practice, internal medicine, and general practice) accounted for nearly half (44.5%) of all dispensed opioid prescriptions. Non-physician prescribers, physician assistants, and
Discussion
The data from 2012 indicate that primary care specialties generated nearly half of dispensed opioid prescriptions, contributed more than half of all prescriptions, and prescribed opioids at a rate near the national average. Not surprisingly, specialties typically associated with the treatment of painful conditions such as pain medicine, physical medicine/rehabilitation, emergency medicine, surgery, and dentistry had high rates of opioid prescribing. Non-physician prescribers, an often
Acknowledgments
CDC funded this study and supported the staff responsible for the design and conduct of the study; the collection, analysis, and interpretation of the data; and the preparation, review, and approval of the manuscript. The views expressed in this article are those of the authors and do not necessarily reflect the official position of CDC or the U.S. Food and Drug Administration.
No financial disclosures were reported by the authors of this paper.
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