Now that physicians can be convicted of murder for irresponsible opiate prescribing, it’s worth reviewing precisely how we’re fulfilling our felonious destiny.
This is a brief look at the prescription drug-related deaths in San Diego County for the year 2013. These authors identified each patient death, performed a pharmacy query for all the medications prescribed in the year prior, and then compiled descriptive statistics regarding the providers and specialties involved. The results are disturbing, yet unsurprising.
- Primary care provided the bulk of prescriptions related to the 254 deaths, whether opiates, benzodiazepines, or sleep aids.
- Regarding opiates, 190 patients amassed 2,350 prescriptions totaling 205,700 pills – over 1,000 per patient.
- Emergency providers were not terribly over-represented, and provided among the fewest pills per prescription, at 22.9.
- The sample sizes of many subspecialties were small, but the 22 orthopedists captured by this analysis provided an average 169 pills each refill.
- “Doctor shoppers” constituted 28% of patients, but received 51% of the total prescriptions. Various surgical specialties seemed to be their primary target.
As irritating as unnecessary antibiotic prescriptions and their ilk may be, this is far more gruesome and disappointing a spectacle.
“Who is prescribing controlled medications to patients who die from prescription drug abuse?”
http://www.ncbi.nlm.nih.gov/pubmed/26476578