Primary Care Doctors Leading Providers of Painkiller Prescriptions, Study Says

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Painkiller PrescriptionsIt is no secret that narcotic painkiller addictions are commonplace in the U.S. In fact, 46 Americans are thought to die every day from prescription painkiller overdose. There were an estimated 2.1 million Americans addicted to narcotics in 2012. That year, healthcare providers had also written 259 million painkiller prescriptions.

In a new study published in the journal JAMA Internal Medicine researchers from the Stanford University School of Medicine found that primary care doctors are mostly to blame for narcotic painkiller prescriptions. Narcotic painkillers are also called opioids or opiates.
For the study, the researchers observed data from the 2013 Medicare Part D prescription drug coverage claim program. The study included narcotic painkiller prescriptions such as codeine, hydrocodone (Vicodin), and oxycodone (OxyContin).

Researchers found that the greater number of narcotic painkillers prescribed in 2013 were from primary care, or family doctors, at 15.3 million prescriptions. Another type of primary care doctor called internal medicine physicians issued 12.8 million painkiller scripts. Nurse practitioners also wrote 4.1 million narcotic prescriptions and physician assistants accounted for 3.1 million prescriptions of narcotics.

Study researchers found that the top 10% of painkiller prescribers justified 57% of painkiller prescriptions.

The current investigation contradicts other studies that indicate that the U.S. painkiller epidemic is fueled by a small number of doctors that run corrupt operations called “pill mills.”
“These findings indicate law enforcement efforts to shut down pill-mill prescribers are insufficient to address the widespread overprescribing of opioids,” explained lead author Dr. Jonathan Chen, who is an instructor of medicine and Stanford Health Policy VA Medical Informatics Fellow. “Efforts to curtail national opioid overprescribing must address a broad swath of prescribers to be effective. The public health epidemic of opioid overuse is perhaps not surprising given the tenfold increase in volume over the past 20 years.”

A previous study from the California Workers’ Compensation Institute in 2011 discovered that one percent of prescribers made up one-third of narcotic prescriptions, and the top 10% of painkiller prescribers accounted for 80% of all narcotic prescriptions. On the other hand, the new study used data from the 2013 Medicare prescription drug coverage claims. The purpose was to find out whether the high painkiller prescribing also occurred at the national level.

The researchers focused on data that included 381,575 prescribers and 56.5 million claims for narcotic painkillers. Centers for Medicare and Medicaid Services data for all prescribers represented 1.18 billion claims and 808,020 prescribers of all prescription drugs.
The study authors credited employment in more injury-prone jobs and a greater prevalence of multiple health conditions for the difference between the Medicare and California Workers’ Compensation data.

The researchers also found that painkiller prescription claims per prescriber were based on pain specialists, pain management, anesthesiology, and physical medicine and rehabilitation.
What are natural painkiller alternatives? Some examples include turmeric or curcumin, topical arnica, ginger, holy basil, omega-3 fatty acids, willow bark, cloves, cat’s claw, olive oil, sandalwood oil, Panax ginseng, capsaicin, Boswellia, methylsulfonylmethane (MSM), and acupuncture treatment.

Sources for Today’s Article:
Chen, J.H., et al., “Distribution of Opiods by Different Types of Medicare Prescribers,” JAMA Internal Medicine, 2015; doi: 10.1001/jamainternmed.2015.6662.
Duff-Brown, B., “Overprescribing of opioids is not limited to a few bad apples,” Stanford Medicine New Center web site;, last accessed December 15, 2015.
Preidt, R., “Primary Care Docs the Leading Prescribers of Narcotic Painkillers: Study,”, December 14, 2015;
“Opioid Painkiller Prescribing,” Centers for Disease Control and Prevention web site;, last accessed December 15, 2015.
Volkow, N.D., “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse,” National Institute on Drug Abuse web site, May 14, 2014;
Balch, J., et al., Prescription for Natural Cures: A Self-Care Guide for Treating Health Problems with Natural Remedies Including Diet, Nutrition, Supplements, and Other Holistic Methods (Hoboken: John Wiley & Sons, Inc., 2004), 50-56.