This Viewpoint discusses strategies for prevent overprescribing of opioids while still effectively treating patients in chronic pain.
A man in his 40s with chronic pain from a traumatic arm amputation, a history of alcohol and cocaine use disorders, and depression presented to the emergency department with suicidal ideation. While he awaited placement at a psychiatric hospital, a member of his care team accessed the state’s prescription drug monitoring program website, revealing a large number of oxycodone and clonazepam prescriptions. How many exactly? A medical student copied the records into a spreadsheet program. The patient had received a 90- to 120-day supply of these medications every month for the last 7 months. Even more curious, “doctor shopping” (receiving prescriptions from different prescribers) could quickly be ruled out because all the prescriptions appeared to be written by his primary care physician.