Study Provides Look Into Surgeons' Opioid Prescribing Patterns

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Researchers have discovered new understandings into the patterns and predictors of opioid prescribing after surgery in a county-level study across the United States. The research results provide a detailed look at how various social and healthcare factors influence opioid prescribing, and are published in the Journal of the American College of Surgeons (JACS).¹

Using data from the 2013-2017 Medicare Part D database, the researchers found:

• The average number of opioid prescriptions per beneficiary (OPBs) decreased from 1.08 in 2013 to 0.87 in 2017.
• There were several factors connected with a higher OPB, including a younger population, higher education levels, and higher healthcare costs.
• Counties with fewer mental health providers and higher uninsured rates also saw higher OPBs.

“In our study, we were surprised by the variance in opioid prescription rates across different states,” said Apostolos Gaitanidis, MD, co-lead author of the study. “This raises important questions about the role of different medical specialties in the opioid crisis. It's a common assumption to associate high opioid prescriptions with surgical practices. However, our findings suggest that the reality is more complex, and that the issue may not be predominantly with surgical prescriptions.”

For instance, the authors noticed that the opioid epidemic was widespread in West Virginia, but observed fewer opioid prescriptions by surgeons compared to states like Louisiana, Alabama, and Missouri, which were not as heavily affected by the epidemic, Dr. Gaitanidis added.

Particularly, the authors found higher OPBs in counties with higher uninsured rates and reduced access to mental health services, which suggests that decreased access to healthcare and mental health services could impact patterns of opioid prescribing after surgery.

“It is likely that in counties with restricted healthcare access, due to higher healthcare costs, lack of insurance coverage, and decreased availability of mental health providers, patients may receive more postoperative opioids, as they might not be able to easily obtain additional opioid pills should they need to, or, more likely, that the higher opioid prescribing is masking an unaddressed overall health and mental health burden in this patient population,” the authors noted.

Counties with higher education levels, which often host major hospitals and referral centers, might see higher opioid prescriptions due to a larger influx of complex cases. On the contrary, better healthcare quality on a county level was associated with a greater drop in OPB over time, according to Dr. Gaitanidis.

The authors also added that the findings highlight the need for a comprehensive approach to addressing pain management and the opioid epidemic, particularly focusing on enhancing mental health services and health care accessibility; however, one limitation to this study is not knowing if a prescription initially made in one county was then diverted to another county or state.

Reference

1. Study reveals key factors in surgeons' opioid prescribing patterns. EurekAlert. January 16, 2024. Accessed January 17, 2024. https://www.eurekalert.org/news-releases/1030806