Clinicians Prescribe 10% Fewer Opioids After Learning of a Patient's Fatal Overdose

Clinicians Prescribe 10% Fewer Opioids After Learning of a Patient's Fatal Overdose

Ever wonder how doctors feel when they hear that a patient they prescribed opioids for has died of an overdose? In light of the current opioid epidemic, it’s even more important to know if they would do anything differently, or just continue prescribing opioids as usual.

Researchers in California set out to find some answers to these questions. They wanted to see if learning about overdose deaths among their patients changed the way they prescribe potentially addictive drugs.

The good news is they found some answers that might help combat the opioid epidemic.

The study, published in the journal Science, revealed that after learning about a patient’s overdose death, clinicians tended to begin prescribing fewer opioid prescription medications – roughly 10% fewer – as well as prescribing smaller doses. And they did this even when a patient’s death occurred as long as a year earlier.

In other words, they were definitely affected – enough to take responsibility and lighten up on opioid prescribing.

Randomized trial

First, the researchers looked into data collected from July 1, 2015 through June 30, 2016 from patients in San Diego County.

They observed 1,279,691 prescriptions filled during the study period, and identified:

  • 170 patients, called “decedents,” who had suffered fatal drug overdoses from schedule II, III, or IV drugs;
  • 861 clinicians who had, at sometime within the past year, written one or more prescriptions for schedule II, III, or IV drugs for one or more of those decedents;
  • Out of the 861 prescribers, 725 had prescribed to only one decedent, and 136 had prescribed to multiple decedents.

That’s most of the complicated stuff.

Next, the 861 clinicians were divided into several groups, called clusters, with each cluster created to be similar in every important aspect to the other clusters, covering numbers of decedents, numbers of prescriptions, etc.

Keep in mind that none of these clinicians had any idea that this study was going on.

Finally, the researchers began their randomized trial by randomly splitting the clusters into two groups, one an “intervention group” and the other a “control group.”

The Chief Deputy Medical Examiner of San Diego County sent the intervention group clinicians a letter notifying them of the deaths of their patients. Clinicians in the control group did not get any letters or anything else.

The letters were the most crucial part of the whole experiment, identifying the decedents by name, address, and age; outlining the types and number of prescription drugs deaths each year documented by the medical examiner; discussed the value of and ways to access the state’s prescription drug monitoring program; and discussed CDC guidelines for safe prescribing strategies.

Now the good stuff

Researchers carefully monitored the prescribing habits of all the clinicians in both groups.

In the following three months, opioid prescriptions written by the letter recipients – the intervention group – decreased by 9.7%. The control group prescribing patterns remained unchanged.

Why did this simple program succeed, where months and months of programs urging opioid prescription changes, from various levels of government, had little impact?

“People rely upon knowledge that is impactful, recent, and easy to retrieve from memory when judging probabilities and making decisions,” the study authors said. “Decisions to avoid harms could occur more frequently after receipt of the letter, because the effects of opioid harms are available to memory.”

The researchers suggested that such a program is “scalable” and could be applied anywhere.

If you or someone you care for is struggling with an addiction to or dependence on drugs or alcohol, call Novus at (855) 464-8550 today. We’ll help connect you to a program that works for you or your loved one.

Related Posts:

Start Your New Path to Sobriety Today!

    • Please enter your name.
    • This isn't a valid phone number.
    • Please enter your email address.
      This isn't a valid email address.
    • Please make a selection.
    • Please enter a message.