The Concentration of Opioid Prescriptions by Providers and Among Patients in the Oregon Medicaid Program

Psychiatric Services : a Journal of the American Psychiatric Association
Hyunjee KimK John McConnell

Abstract

This study examined the distribution of opioid prescribing across providers and patients and the extent to which concentrated distribution predicts opioid misuse. Using 2013 Oregon Medicaid claims and the National Provider Identifier Registry, this study identified patients who filled at least one opioid prescription and providers who prescribed opioids for those patients (N=61,477 Medicaid beneficiaries). This study examined the distribution of opioid prescriptions by provider and patient, the extent to which high-volume opioid use was associated with potential opioid misuse, and how this association changed when patients received opioids from providers in the top decile of morphine-equivalent doses (MEQ) prescribed in 2013. This study used four indicators of opioid misuse: doctor and pharmacy shopping for opioid prescriptions, opioid prescription overlap, and opioid and benzodiazepine prescription overlap. Opioid use and prescriptions were heavily concentrated among the top 10% of opioid users and prescribers. Those high-volume opioid users and prescribers accounted for, respectively, 83.2% and 80.8% in MEQ of entire opioids prescribed. Patients' increasing use of opioids (by MEQ) was associated with most measures of opioid m...Continue Reading

Citations

May 3, 2016·Journal of Child and Adolescent Psychopharmacology·Tracy A KleinKenn Daratha
Jul 29, 2017·Journal of General Internal Medicine·Richard L Kravitz
Jun 30, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Brian KimLianping Ti
May 12, 2020·The Journal of Arthroplasty·Lia D DelaneyJennifer F Waljee
Apr 8, 2021·Substance Abuse Treatment, Prevention, and Policy·Sukhada S JoshiPaul M Griffin
Oct 21, 2018·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Shari S RogalWalid F Gellad
Jan 30, 2020·Preventive Medicine Reports·Rosanna SmartBradley D Stein

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