Nearly Half Of Patients Prescribed Opioids Don’t Need Them: Study

About half of all patients who undergo surgery do not actually need prescriptions for opioid painkillers at discharge, but are often given the powerful and addictive drugs anyway. 

A new Massachusetts-based study highlights the widespread overprescription of narcotic painkillers, despite not administering the drugs before discharge. The findings were published last month in the journal JAMA Surgery.

Data for more than 18,000 patients who underwent surgery at Boston Medical Center and Lahey Hospital and Medical Center-Burlington Campus medical centers were analyzed from May 22, 2014, to September 7, 2016. Patients were discharged home after inpatient surgery admission of at least 24 hours. Data included more than 21,000 surgical procedures.

Overall, patients had a wide variation in the amount of opioids prescribed to them at hospital discharge. This was especially the case considering a patient’s individual 24-hour pre-discharge opioid use.

More than 46% of patients that no longer used opioids prior to hospital discharge were still prescribed opioids at their hospital discharge.

Patients who were not experiencing pain, nor using narcotic painkillers to treat the pain, were prescribed opioids nonetheless. Researchers warn that the data suggests many surgical patients may be overprescribed opioids based on these findings, as this is common practice in many hospitals across the country.

The findings are particularly worrisome considering the worsening opioid epidemic throughout the U.S. A recent CDC report indicated the number of opioid drug overdose deaths kills more Americans each year than breast cancer.

A study published last year indicated opioid abuse problems are worsening in the U.S. and may be severely underreported. A CDC study indicated death rates due to opioid use may be much higher than estimated.

Study authors noted departments with the highest overprescription rates included obstetrics, gynecology, and orthopedics. Plastic surgery patients typically had the highest rates of patients still using opioids at hospital discharge.

Pediatric surgery was the only department that did not have any cases of potential overprescription.

“Potential overprescription of opioids occurs frequently among postoperative patients; improved opioid prescribing practices are needed to administer opioids in a more patient-specific manner,” the researchers wrote.

Another recent study of nearly 350,000 adults indicated the proportion of adults taking Neurontin, a drug often used to combat opioid addiction, more than tripled in recent years. In fact, the increase was primarily driven by chronically ill older adults and those already taking opioids painkillers. In fact, Americans are taking more prescription drugs than ever. Prescription opioid use increased by 300% from 1999 to 2010.

Another study published in 2017 indicated fewer opioids after surgery, especially hernia repair, was needed than surgeons initially believed. The findings of this study call into question the common practice of offering surgical patients high levels of narcotic painkiller prescriptions after surgery.

The FDA warns that doctors should undergo further education concerning opioid prescribing, in an effort to mitigate the worsening opioid abuse crisis.