9 of every 10 patients receive painkiller prescription after overdose

The Centers for Disease Control and Prevention estimate that each day, 46 people die from an overdose of prescription painkillers in the United States. For example, insurance companies might be able to provide information on overdoses to doctors, which could help them spot patients who are having problems with the drugs, Larochelle said.

According to the authors, the findings highlight the challenges faced by physicians to balance the known risks with potential benefits of prescription opioids for patients with chronic pain.

Oxycodone, which includes the brand-name drug OxyContin, and hydrocodone, which is in the brand-name drug Vicodin, continue to be among the most commonly prescribed narcotic painkillers, and are responsible for more overdose deaths than any other narcotic, the researchers found.

The study underlined the need for careful weaning of people off opioids after an overdose, both D’Onofrio and Larochelle said.

Eight percent of those whose prescriptions were stopped went on to have another overdose in the next two years, which is lower than those who continued to have a prescription, but still concerning, Larochelle said.

“After an overdose, a provider can terminate the prescription, knowing that his or her patient will suffer withdrawal and may turn to illicit opioids for relief, or the provider can continue the prescription, knowing that that medication may ultimately do more harm than good”, Gregg said.

Dr. Marc Larochelle, who studies addiction issues at the Boston University School of Medicine, wrote that prescribing guidelines “clearly state that misuse of opioids and adverse effects are compelling reasons to discontinue opioids”.

LaRochelle said prescribing physicians should not be blamed, and that the numbers are more a sign of a broken health care system. The study, reported in the Annals of Internal Medicine, says doctors seem to be largely unaware their patients have even had an overdose. Previous studies have found patients’ regular doctors – not pill mills or shady pseudo-doctors – are writing most of the prescriptions, and have difficulty balancing managing pain and working to prevent an abuse or dependence problem. Some patients suffered another overdose, as a result. Also, doctors may be reluctant to draw down medication if patients insist it is the only thing that manages their pain and helps them get out of bed in the morning and tend to their families.

The bill also provides $12 million in funding for residential drug treatment programs, $13 million for prescription drug monitoring and $42 million for drug courts and the CDC’s state-based anti-drug program. Almost half of those surveyed by researchers at the Johns Hopkins Bloomberg School of Public Health believed, incorrectly, that a group of opioids made with hard shells or other abuse deterrents were less addictive than their counterparts. The fact of the matter is that many doctors are dependent on patients letting them know they overdosed, and most patients aren’t likely to do that.

The researchers used Optum, a national commercial insurance claims database, to identify nearly 3,000 patients who experienced a nonfatal overdose between 2000 and 2012 while taking long-term opioids prescribed for chronic pain not related to cancer.

The study was funded by the Health Resources and Services Administration, part of the U.S. Department of Health and Human Services.