By definition, essentially, all prescription drug abuse starts with a prescription. Diversion and misuse cannot occur without a physician – well-meaning or not – at the start of the chain. And, not only are physicians the pipeline for maintaining supply in the community – they’re also one of the sources for minting new abusers.
This simple retrospective study looked at Emergency Department patients receiving treatment for an acutely painful condition. Patients were then distilled down into those without prior use of opioids within the previous one year – the so called “opioid naive” for the purposes of this classification. Approximately half of these patients received an opiate prescription at discharge.
Two interesting observations:
- Those receiving, and filling, a prescription for opiates were far more likely than those who did not receive a prescription – 17% vs. 10% – to fill another prescription for opiates in a 60-day time period one year later.
- Those receiving, but not filling, a prescription for opiates had only an 8% prevalence of filling another prescription for opiates a year later.
Within the limitations of the selection biases inherent to a such a retrospective evaluation – the message is reasonable: beware the downstream harms of every opiate prescription provided.
“Association of Emergency Department Opioid Initiation With Recurrent Opioid Use”
http://www.ncbi.nlm.nih.gov/pubmed/25534654