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January 2016

Strategies for Flipping the Script on Opioid Overprescribing

Author Affiliations
  • 1Yale School of Medicine, New Haven, Connecticut
  • 2Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3VA Connecticut Healthcare System, West Haven, Connecticut
JAMA Intern Med. 2016;176(1):7-8. doi:10.1001/jamainternmed.2015.5946

A man in his 40s with chronic pain from a traumatic arm amputation, a history of alcohol and cocaine use disorders, and depression presented to the emergency department with suicidal ideation. While he awaited placement at a psychiatric hospital, a member of his care team accessed the state’s prescription drug monitoring program website, revealing a large number of oxycodone and clonazepam prescriptions. How many exactly? A medical student copied the records into a spreadsheet program. The patient had received a 90- to 120-day supply of these medications every month for the last 7 months. Even more curious, “doctor shopping” (receiving prescriptions from different prescribers) could quickly be ruled out because all the prescriptions appeared to be written by his primary care physician.

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