While legislators are attempting to tackle the opioid crisis by enforcing regulation, these researchers have found success in another kind of approach.
As a means of alerting physicians to the dangers and realities of overprescribing, the researchers worked through a local medical examiner to send letters to 381 physicians in San Diego County, California concerning their former patients.
Based on actual cases, the letters informed the physicians that a patient to whom they had given an opioid prescription had passed away of a fatal overdose. Enclosed with the letter was a CDC-approved set of guidelines for how health care professionals should safely be prescribing opioids.
Though the premise is sobering, the study results proved to be successful – clinicians who received the letters prescribed 10% less opioids than the clinicians in the control group who did not receive the letters. Not only that, physicians who received the notices were overall less likely to start patients on opioids and less likely to give patients higher doses of opioids.
“Most people addicted to opioids began taking them because they were legally prescribed. Little attention has been paid to changing physicians’ prescribing behavior,” reads the study results, which were published in Science last month.
“[Additionally], most opioid prescription deaths occur among people with common conditions for which prescribing risks outweigh benefit. General psychological insights offer an explanation: People may judge risk to be low without available personal experiences, may be less careful than expected when not observed, and may falter without an injunction from authority.”
The team emphasizes that while their results are a positive nudge in the right direction, it is not the final solution. However, implementing smaller, more personalized approaches are a welcomed balance to passing more sweeping pieces of legislation that may prevent patients who actually require opioid prescriptions from getting the medication they need.
“I reached out to experts with a question: How do you fix opioid overprescribing without leaving behind pain patients?” said Vox journalist German Lopez. “Part of the solution, experts told me, are nudges like that in the Science study, instead of mandates and caps like [some] state governments have enacted. It’s also important to make non-opioid pain treatment available to patients, while training health care providers in the right way to wean patients off opioids.
“These solutions, though, need to come together to strike a balance — because there is no one silver bullet to solving this problem.”
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