Wide Variations in Pain-Killers Prescribed by Family MDs

(Photos8.com)

Some family physicians are prescribing opioids such as OxyContin at rates many times higher than their peers, according to a study by researchers at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences (ICES) in Toronto, Canada. The study, published online in the journal Canadian Family Physician, also showed an association between the number of deaths related to opioid use and their physicians’ rates of prescribing those drugs.

Opioid analgesics are controlled substances that suppress perceptions of pain and calm emotional responses to pain by reducing the number of pain signals sent by the nervous system and the brain’s reaction to those pain signals. Patients may become physically dependent on opioids if taken regularly. Physical dependence is not addiction but it is a gradual change in the body’s response to the opioids.

The study of prescription records in Ontario showed family physicians, with the highest rates of opioid prescriptions were 55 times more likely to prescribe these drugs than colleagues with the lowest rates. The top quintile — the top 20 percent of the total sample arrayed by opioid prescription rates — was also 4.5 times higher to prescribe opioids as the second quintile. The researchers excluded methadone, prescribed for opioid addiction rather than pain, and physicians who practiced outpatient palliative care.

The study also investigated coroner records in Ontario for deaths related to opioid use. A postmortem examination, generally including detailed toxicologic testing, is conducted by or for the coroner to determine the cause of death.

Of the 408 adults whose deaths were related to opioids in 2006, 166 (41%) received at least one publicly funded opioid prescription in the year before death. Of this group, 102 (61%) received their final prescription before death from family physicians.

And of those 102 individuals who died as a result of opioids and received prescriptions from family physicians in the year before their death, 64 (63%) received their prescriptions from family physicians in the highest-prescribing quintile. The researchers found an association between the number of opioid-related deaths that increased across the prescribing-volume quintiles.

Read more:

• Study: Youth Prescriptions Nearly Double Since 1994
• Drug-Related Hospitalizations Double for Age 45+

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