Prescription that enhances opioid addiction

Emergency room patients treated by physicians who prescribe opioids more often are at greater risk for long-term opioid use even after a single prescription than those who see less-frequent prescribers, according to the findings of a study from Harvard Medical School and T.H. Chan School of Public Health.

The research, believed to be the first to measure variation in provider prescribing practices and their impact on long-term opioid use, is published in the New England Journal of Medicine. Long-term opioid use increases the danger of misuse, addiction and even overdose, fueling what public health experts have called a national epidemic of opioid overuse.

In 2015, more than 15,000 people in the United States died from an overdose involving prescription opioids, according to the Centers for Disease Control and Prevention. The findings, the researchers add, underscore an acute need to educate clinicians on judicious prescribing practices and reduce wide variation in prescribing patterns for similar patients.

“These are sobering results,” said lead study author Michael Barnett, assistant professor of health policy and management at the Harvard Chan School and an HMS instructor of medicine at Brigham and Women’s Hospital. “Our analysis suggests that one out of every 48 people newly prescribed an opioid will become a long-term user. That’s a big risk for such a common therapy.” Specifically, the study found that patients who saw frequent or so-called high-intensity, opioid prescribers were three times as likely to receive a prescription for opioids as patients seen by infrequent, or low-intensity, prescribers in the same hospital.