Primary Care Physicians Prescribe the Most Opioid Painkillers

A new study of Medicare data finds primary care physicians prescribe significantly more opioid painkillers than any other type of doctor.

The study of data from Medicare Part D prescription drug coverage claims found family practice doctors issued 15.3 million opioid prescriptions in 2013, while internal medicine physicians issued 12.8 million.

Nurse practitioners wrote 4.1 million prescriptions for opioid painkillers, HealthDay reports. Physician assistants wrote 3.1 million opioid prescriptions.

The results appear in JAMA Internal Medicine.

In a news release, lead researcher Dr. Jonathan Chen of Stanford University said, “These findings indicate law enforcement efforts to shut down pill-mill prescribers are insufficient to address the widespread overprescribing of opioids. Efforts to curtail national opioid overprescribing must address a broad swath of prescribers to be effective.” He added, “Being a physician myself, I am acutely aware of the emotional angst that can occur when deciding whether to prescribe opioids to a patient who may have simultaneously developed a chronic pain and substance-dependence problem.”
Recently, the Centers for Disease Control and Prevention (CDC) released draft guidelines for physicians who prescribe opioid painkillers, which call for a more conservative approach to the drugs’ use.

The guidelines recommend doctors treat chronic pain with methods such as physical therapy and non-opioid painkillers before prescribing opioids. If doctors choose to prescribe opioids, they should select short-acting versions instead of extended release formulations, the guidelines recommend. Doctors should also prescribe the lowest possible dose, for shorter periods, the CDC said.