Why varying opioid prescription standards could be hurting Americans

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Researchers say prescriptions for minor injuries leads to risk of long-term use

Depending on where you live, you can expect to be prescribed varying amounts of opioids for even minor injuries. Experts are now saying that fact is contributing to the rising number of opioid-related deaths in the U.S.

In a recent study, researchers from the University of Pennsylvania found that patients who received their first opioid prescription for a sprained ankle received anywhere from 15 to 40 pills. This is dangerous, they say, because findings also suggest that receiving over 30 pills led to higher rates of additional opioid prescriptions being filled out within three to six months.

"The substantial variation in prescribing patterns of such extremely addictive medications for minor injuries results in many thousands of pills entering the community, and places patients at an increased risk of continued use and potentially addiction. It's vital that we identify and understand the root causes of this growing issue," said lead author Dr. M. Kit Delgado.

Varying standards

For the purposes of the study, the researchers analyzed private insurance claims for more than 53,000 emergency department patients across the country who were admitted for an ankle sprain between 2011 and 2012. None of the patients in the study had filled an opioid prescription out within the past six months of their visit, and approximately 7% of them were prescribed an opioid pain medication like hydrocodone or oxycodone.

The data showed that the prescription practices for these injuries varied wildly from state to state. For example, only 1.6% of patients in Delaware received a opioid prescription for their injury, while 16% of patients received one in Mississippi. Further, the researchers say that the wide discrepancy in the number of pills prescribed can often flood communities with pills.

"Looking only at the cases analyzed in this study, if all prescriptions written for more than 20 pills were instead written for only 20, there would have been 37,721 fewer opioid pills entering the community. If extrapolated more broadly to the treatment of other minor injuries, this likely translates to millions of highly addictive and unnecessary prescribed pain medications filtering into the community,” said Delgado.

"Unnecessary and risky"

The researchers point out that certain minor injuries may not warrant an opioid prescription at all, and that certain young patients, who may be more susceptible to their addictive properties, may suffer in the long run from having one.

“Exposing young patients with an ankle sprain to opioids is unnecessary and risky. To limit the escalation of the opioid epidemic in this country, it's critical to keep these medications limited to patients whose injuries absolutely require them, and limit exposure to opioids for all other patients," said senior author Dr. Jeanmarie Perrone.

“The study illustrates the potential benefit of laws to limiting new opioid prescriptions for acute pain to no more than five-day supply as was recently passed in New Jersey," added Delgado.

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