What Reduced Opioid Prescribing Means for Patients and Policy

January 4, 2017

New polling data from The Boston Globe reveals that U.S. physicians are prescribing fewer opioids. But how does the trend impact patients – and the nation’s opioid addiction epidemic?

The Boston Globe Data

The Globe’s December SERMO poll of nearly 3,000 physicians reveals that:

  • More than half of all physician respondents reduced their opioid prescribing over the past two years
  • More than two-thirds of internal medicine and family practice physicians reduced their opioid prescribing over the past two years
  • Thirty-four percent cited “too many hassles and risks” as their rationale for reducing prescriptions
  • Twenty-nine percent credited an “improved understanding of opioids’ risks”
  • More than one-third of physicians agreed that reducing opioid prescriptions may actually hurt patients.

Impact on Patients

As the data reveals, some physicians worry about how limiting opioid prescriptions may affect patients in pain. Consider patients with chronic pain, who may take opioids under the care of their physician and depend upon them for daily functioning.

And the poll does not explore which – if any – alternate treatment options are offered to patients whose physicians cut opioid prescribing or abandon the medications altogether. Balanced approaches that integrate pharmacologic and non-pharmacologic options (such as physical therapy and chiropractic care) can be effective. But not all health plans cover the costs of these interventions.

Without sufficient alternatives, patients may find themselves in a treatment conundrum – and in intolerable pain.

[WATCH: Understanding Balanced Pain Management]

Policy Implications

It’s also unclear how reduced prescribing might impact opioid abuse and addiction on a national scale. Late 2016 data from Massachusetts, for example, revealed that street drugs – not prescription opioids – drive the state’s overdose epidemic. The state’s department of health reported that 85 percent of overdose death toxicology reports showed the presence of heroin or fentanyl. A similar trend has emerged in other states, including Alabama.

Thus, policymakers eager to address the opioid epidemic would be wise to take a balanced approach. Reductions in opioid prescribing should stem from informed decisions about what’s best for individual patients, not from physicians’ fear of stigma or frustration with growing regulations. And health plans would do well to ensure that, where opioids’ availability diminishes, other pain management options are accessible to patients who need them.

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