“[The finding] suggests at least some increased level of drug dependence in patients prescribed opioids as initial therapy, and reinforces the idea that emergency departments do play an important role when it comes to the opioid epidemic,” Dr del Portal emphasized.

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Prescription drug overdoses are the leading cause of death due to injury, and such overdose-related deaths increased consecutively from 1999 to 2010, while the sale of opioids increased four-fold over the same time period.5

Opioid Prescribing Are Rates Dropping

Study results showed that only 12% of patients received opioids within the specified time frame — a number that the investigators found to be ‘unexpectedly low’ and suggestive of a decline in prescribing practices.

“This is the first study I’m aware of that suggests that recent efforts to discourage opioid prescribing for uncomplicated LBP may be having a modest impact on clinical practice, as the rate was lower than past studies, and the impact on disability was seen most only at high doses,” David Deitz, MD, PhD, a healthcare analyst and consultant at David Deitz and Associates in Boston, MA, told Clinical Pain Advisor.

“The California Workers Compensation Institute has recently published data6 showing modest decreases in opioid prescription claims in that state, also suggesting that changes in practice may be occurring,” Dr Deitz pointed out.

The low rate of prescriptions found in the current investigation was also surprising to Dr. del Portal, who believes the number is likely higher in most EDs, though he has found additional evidence of overall decreasing rates.

Citing a recently coauthored study, Dr del Portal noted that the number of LBP patients receiving a discharge prescription for opioids fell from about 50% to below 30% after implementation of prescribing guidelines at Temple University.2