Conflict of Interest/Disclosure Summary: This work was supported in part by a research grant from the Centers for Disease Control and Prevention (5 R21 CE001612). The Utah Department of Health provided additional funding and support for the project.
Original Research Article
Specialty of Prescribers Associated with Prescription Opioid Fatalities in Utah, 2002–2010
Article first published online: 9 OCT 2013
Wiley Periodicals, Inc
Volume 15, Issue 1, pages 73–78, January 2014
How to Cite
Porucznik, C. A., Johnson, E. M., Rolfs, R. T. and Sauer, B. C. (2014), Specialty of Prescribers Associated with Prescription Opioid Fatalities in Utah, 2002–2010. Pain Medicine, 15: 73–78. doi: 10.1111/pme.12247
- Issue published online: 16 JAN 2014
- Article first published online: 9 OCT 2013
- Centers for Disease Control and Prevention. Grant Number: 5 R21 CE001612
- Utah Department of Health
- Physician Performance
Opioid adverse events are widespread, and deaths have been directly attributed to opioids prescribed by medical professionals. Little information exists on the amount of opioids various medical specialties prescribe and the opioid fatality rate that would be expected if prescription opioid-related deaths were independent of medical specialty.
To compute the incidence of prescription opioid fatalities by medical specialty in Utah and to calculate the attributable risk (AR) of opioid fatality by medical specialty.
Prevalence database study design linking the Utah Controlled Substance Database (CSD) for prescribing data with the Utah Medical Examiner data to identify prescription opioid fatalities. AR were calculated for each medical specialty and year.
Opioid prescriptions are common with 23,302,892 recorded in the CSD for 2002–2010, 0.64% of which were associated with a fatality. We attached specialty to 90.2% of opioid prescriptions. Family medicine and internal medicine physicians wrote the largest proportion of prescriptions (24.1% and 10.8%) and were associated with the greatest number of prescription opioid fatalities. The number of active prescriptions at time of death decreased each year. The AR of fatality by provider specialty varied each year with some specialties, such as pain medicine and anesthesiology, consistently associated with more fatalities per 1,000 opioid prescriptions than internal medicine physicians the same year.
Primary care providers were the most frequent prescribers and the most often associated with opioid fatalities and should be targeted for education about safe prescribing along with specialties that prescribe less frequently but are associated with a positive AR for opioid fatality.