Emergency Room Doctors Prescribe More Opioids Than They Realize: Study

Amid the ongoing opioid abuse and addiction crisis in the United States, a new study suggest that emergency room physicians often underestimate the amount of painkiller prescriptions they write. 

Researchers from the Department of Emergency Medicine at the University of Colorado found that doctors will prescribe fewer narcotics in the future, if they are aware how many prescriptions they are currently writing.

In a report published in the medical journal Academic Emergency Medicine on April 2, researchers outlined the results of a 12 month data-driven intervention randomized trial of nearly 110 attending physicians, residents, and advanced practice providers at four emergency rooms in Colorado. In total, the doctors wrote more than 15,000 prescriptions for opioids. This represented about 20% of the prescriptions they wrote overall.

Doctor prescribing habits have been highlighted in the wake of the worsening opioid abuse epidemic. Research indicates opioids account for two-thirds of all drug overdose deaths in the United States, and many point to prescriptions as the starting point.

Some studies indicate excess opioids are often prescribed following hip and knee surgeries, and most patients who have hernia surgery can use lower doses. Other research warns that half of all patients prescribed narcotic painkillers don’t actually need them for pain relief.

Research indicates ER doctors write about 5% to 10% of all opioid prescriptions. One study indicated ER doctors often prescribe opioids for lower doses and shorter durations than other doctors.

This latest study asked ER doctors to estimate what their opioid prescribing habits were, indicating how many prescriptions they thought they wrote for opioids like Vicodin or Percocet.

Then doctors were randomly assigned to be in the no intervention group or the intervention group. The data-driven intervention group was told exactly how many opioids they prescribed, compared to their peers.

More than 65% of doctors underestimated their opioid prescribing, thinking they prescribed fewer opioids than they really did. Once faced with their true prescribing habits, prescribing decreased.

Doctors who underestimated their narcotic painkiller prescribing wrote two less prescriptions per 100 patients after they were given their actual prescribing data.

The doctors who did not underestimate their prescribing habits saw similar changes in prescribing, or none at all, compared to the control group.

“Providing clinicians with their actual opioid prescribing data after querying their self‐perception reduced future prescribing among providers who underestimated their baseline prescribing,” the researchers wrote.

The findings of the study are in line with similar studies which indicate opioid prescribing drops when doctor prescribing habits are monitored.