Guidelines Help Prescribers Avoid Overprescribing Opioids

Problem:

Despite recent declines, opioid prescribing is still high and inconsistent across the United States. The amount of opioids prescribed per person was three times higher in 2015 (640 morphine milligram equivalent [MME]) than in 1999 (180 MME).

Characteristics of counties with higher opioid prescribing:

  • Small cities or large towns
  • Higher percent of white residents
  • More dentists and primary care physicians
  • More people who are uninsured and unemployed
  • More people who have diabetes, arthritis or disability

To avoid overprescribing opioids, physicians and other health care providers can:

  • Follow the Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain1, which includes such recommendations as using opioids only when benefits are likely to outweigh risks.
  • Start with the lowest effective dose of immediate-release opioids. For acute pain, prescribe only the number of days that the pain is expected to be severe enough to require opioids.
  • Reassess benefits and risks if considering dose increases.
  • Use state-based prescription drug monitoring programs (PDMPs), which help identify patients at risk of addiction.

Physicians and other health care providers can find more information at www.cdc.gov/vitalsigns/opioids (opens in new window).

Humana Pharmacy Solutions reviews pharmacy claims data2 to identify patients who may be overutilizing opioid prescriptions on a regular basis. Opioid overutilization is based on a morphine equivalent dose exceeding 120 mg for at least 90 consecutive days with more than three providers and more than three pharmacies contributing to opioid claims during the most recent 12 months2. Review is critical in prevention of misuse, abuse and serious adverse events.

1“Prescribing Opioids for Chronic Pain,” Centers for Disease Control and Prevention (www.cdc.gov/drugoverdose/prescribing/guideline.html (opens in new window)).
2Humana prescription claims data.