JAMA Ophthalmology, November 2017
Drug overdose is a leading cause of death among American adults, and the abuse of prescription opioids is a growing public concern. Patel and Sternberg looked at the role of ophthalmologists in the opioid abuse epidemic. They found that most practicing ophthalmologists use discretion in prescribing opioids to their patients.
For this study, the researchers collected Medicare Part D prescriber data pertaining to opioid drugs for all participating ophthalmologists from 2013 to 2015. Documented details included the number of original prescriptions and refills, the number of days’ supply, and prescribing rates. The mean annual number of opioid prescriptions written by ophthalmologists was calculated and compared with the number of overall prescriptions issued. The researchers also noted the geographic distribution of the opioid prescriptions.
The number of ophthalmologists varied by study year from 19,587 to 19,712. Although most (88%-89%) issued 10 or fewer opioid prescriptions each year, approximately 1% wrote more than 100 such prescriptions annually (mean supply, 5 days); this remained constant for each year of the study. Nearly half of ophthalmologists did not issue any opioid prescription or refill during the study period (44% in 2013 to 49% in 2015). The mean number of opioid prescriptions written by ophthalmologists, including refills, was similar for the 3 years.
Among the ophthalmologists who wrote more than 10 opioid prescriptions each year, these drugs represented only 8% (mean) of their total annual prescriptions. Geographically, Alabama, Arkansas, Georgia, Oklahoma, Tennessee, and Texas had the highest volume of opioid prescriptions, while Alaska, Iowa, New Jersey, North Dakota, South Dakota, Vermont, and Wyoming had the lowest volume. The District of Columbia also was a low-volume location.
The authors noted that advancements in ophthalmic surgery may contribute to the relatively fixed opioid prescribing rates in ophthalmology as opposed to the rising rates in other surgical specialties. Even so, they cautioned, “the current epidemic highlights the substantial risk of opioid dependency even with seemingly innocuous prescribing patterns.”
The original article can be found here.