New studies explored whether medical professionals are adhering to stricter opioid prescribing rules and regulations.
While rules and regulations are often made in the interest of public safety, that doesn’t mean they are always followed hard and fast.
Such is the case with certain rules regarding opioid prescriptions, according to the Boston Globe. The paper states that according to the results of two studies published Wednesday (August 22) in the journal JAMA Surgery, “such well-intentioned efforts sometimes don’t have the desired effect.”
The first study concluded that after one rule made it more difficult to refill the painkiller hydrocodone, surgeons began prescribing more of the medication right after surgery instead.
Meanwhile, the second study examined a regulation which required surgeons to check a database before prescribing opioids, the idea being that the database would alert them to patients at risk of opioid misuse.
However, the study found that the procedure took up surgeons’ time but did not affect their prescribing practices in one New Hampshire hospital.
According to the Globe, both the studies were limited in terms of geographic area and only studying surgeon’s prescribing behaviors.
Dr. Michael Barnett, a Harvard health-services researcher who studies opioid prescribing, tells the Globe that the results point to a bigger problem.
“Clinician behavior is harder to predict, when you put these kinds of limits on it, than we’d like to think,” he said. “Regardless of the law you put in place, physicians are going to respond to what patients need… We need to ask a harder question: How do we influence health care decisions?”
Prescribing practices have been under scrutiny for a number of years. In 2014, the Globe states, the U.S. Drug Enforcement Administration (DEA) changed hydrocodone from a Schedule III to a Schedule II drug, meaning patients would not be able to refill it over the phone.
After that went into effect, researchers at the University of Michigan chose to study the effects on post-surgery prescribing. They looked at prescriptions for 21,955 patients who had had elective surgery in 75 Michigan hospitals from 2012 to 2015. Study authors found that prescription refills decreased, but the number of pills a patient left the hospital with increased.
According to study author Dr. Michael Englesbe, the idea seemed to be that if doctors gave patients more prescriptions, they would be more likely to have the necessary pain relief and not seek more medication.
However, Englesbe says, previous research indicates that “the number of pills you give someone has no relationship to their likelihood of calling for a refill. The more pills you give a patient, the more they take, and they don’t rate their pain care any better. It’s counterintuitive.”
