A Different Approach to the Opioid Crisis

When it comes to combating our nation's opioid epidemic, we should focus on taking away matches, not just extinguishing fires. And that means addressing the issue of overprescribing. 

This is the approach of Marty Makary, MD, a Johns Hopkins surgeon and co-director of Practicing Wisely, an Oliver Wyman initiative that aims to reduce unnecessary care, improve patient outcomes, and lower costs by providing clinicians with appropriateness measures. In his op ed, published August 4 in USA Today, Dr. Makary discusses how physicians, himself included, unknowingly contribute to the opioid epidemic by writing excessive prescriptions. They do so, he explains, because they lack guidance on the appropriate prescription amounts for their patients, in their respective specialties.

As a result, we now see a wide variation in physician prescribing patterns. Dr. Makary highlights research that shows the range of physicians' prescribing patterns. For example, some providers prescribe 3 to 10 opioid tablets after routine C-section, while others prescribe more than 60 tablets. Because the longer people use opioids the more likely they are to become addicted, this type of variation significantly factors into a patient’s likelihood of developing an opioid addiction.

Fortunately, we can readily address physician variation and overprescribing. First, we can identify physicians who routinely overprescribe by analyzing prescribing patterns and comparing the results to physician-developed "appropriateness" levels. Healthcare organizations can then arm these physicians with clear guidance on appropriate prescribing. As physicians begin to curb their prescribing patterns towards appropriate levels, we combat at least one factor fueling the opioid epidemic. Read Dr. Makary's op ed here.