Opioid Prescription Practice Behavior among Medical and Surgical Specialty Physicians

Background: The overprescribing of opioids is growing and prescribing rates are highest among pain medicine and surgical specialties. Objective: To evaluate the opioid prescription practice behavior among medical specialty physicians (MSP) and surgical specialty physicians (SSP). Methods: A survey was sent to all physicians at two major institutions. The primary outcome measure was total opioid prescription rate and duration per specialty. The secondary outcome measure was pre-evaluation, counseling, multimodal pain management, and Prescription Drug Monitoring Program (PDMP) query rate. Result: 84.0% (n = 217) of MSP and 93.0% (n = 129) of SSP prescribed opioids during the past year. Prescribing opioids for >2 weeks was significantly more common in MSP vs. SSP (34% vs.14%, p < .001). More MSP than SSP expressed concerns about patients developing opioid dependence (90% vs. 77%, p = .004). MSPs were more likely than SSPs to evaluate the patient's history of substance abuse and to provide counseling for proper opioid use and disposal (p < .05). Only 58% (N = 176) of the MSP and 50% (N = 63) of SSP queried the PDMP every time before prescribing opioids (p = .092). Conclusion: >2- week opioid prescriptions were significantly more common in MSP, but they were also much more likely to thoroughly discuss opioid use and abuse with patients compared to SSP. A more compliant use of PDMP is encouraged.