A new analysis may have uncovered one of the factors that help drive the opioid epidemic in the United States. Researchers have found that nearly 30 percent of opioid prescriptions do not have documented reason.
In a new study, which was published in the Annals of Internal Medicine on Sept. 11, a team of researchers analyzed data from the National Ambulatory Medical Care Survey covering the years 2015 and 2016.
The annual survey is conducted by the U.S. Centers for Disease Control and Prevention to track the reason behind people’s visit to the doctors’ office, what diagnoses, treatments and services they received, and the medications prescribed to them.
The researchers found that of the 809 million doctor visits that involved opioid prescription, 66 percent were for treatment of non-cancer pain. Five percent were for cancer-related pain, and 28.5 percent did not have a record of pain or a condition that causes pain.
“For these visits, it is unclear why a physician chose to prescribe an opioid or whether opioid therapy is justified,” said study author Tisamarie Sherry, an associate physician policy researcher at Rand Corporation, as reported by the CNN. “The reasons for this could be truly inappropriate prescribing of opioids or merely lax documentation.”
The numbers show that in patients already prescribed with opioids, roughly one in three had no recorded pain diagnosis. This is more than the number of people who received a new opioid prescription, suggesting that more people refilled their prescription without clear medical reason than those who received new prescriptions.
“Absence of a pain diagnosis was more common among visits in which an opioid prescription was continued (30.5% [CI, 29.0% to 32.0%]) than those in which an opioid was newly prescribed (22.7% [CI, 20.6% to 24.8%]),” Sherry and colleagues wrote in their study.
The researchers did not make a conclusion that the prescriptions were inappropriate since the information is not enough to make this judgment.
In a statement published by the Harvard Medical School, Sherry said that the absence of clear documentation could be a symptom of deep systemic issues that prevent note-keeping in doctors. The problems could be rooted in complicated documentation interfaces and time pressure.
The researchers said that their study should prompt policymakers to find ways to simplify the clinical documentation systems.
The United States faces an opioid epidemic. Figures from the CDC show that more than 630,000 people have died from drug overdose between 1999 and 2016. Two-thirds of drug overdose deaths in 2016 involved an opioid. About 115 Americans die every day from opioid overdose.