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Volkow ND, McLellan TA, Cotto JH, Karithanom M, Weiss SRB. Characteristics of Opioid Prescriptions in 2009. JAMA. 2011;305(13):1299–1301. doi:10.1001/jama.2011.401
To the Editor: Opioid analgesics, while important for the treatment of pain, are associated with high rates of abuse. Most abusers report they obtained prescriptions on their own or medications from friends and relatives who had been prescribed opioids. We analyzed prescription practices in the United States to identify possible contributors to the high rate of opioid analgesic abuse. We paid particular attention to prescription practices in youth, for whom prescriptions of controlled medications, including opioids, have nearly doubled between 1994 and 2007.1
The data were acquired through the Vector One: National (VONA) database from SDI Health (Plymouth Meeting, Pennsylvania). SDI receives prescription data from 35 015 of the 62 132 retail pharmacies in the United States. These pharmacies dispense nearly half of all retail prescriptions nationwide. Detailed information about SDI's coverage statistics is proprietary. SDI receives 1.4 billion prescription claims per year representing 121 million unique patients. The sample is nationally representative. More detailed information about VONA can be obtained elsewhere.2 We analyzed opioid prescriptions in 2009 as a function of physician specialty (using SDI descriptors), patient age, duration of prescription, and whether the patient had filled a prior prescription (from the same or a different provider) for an opioid analgesic within the past month. We compared differences between prescriptions by age groups and by medical specialty using 2-sample t tests (SAS version 9.1; SAS Institute, Cary, North Carolina). To avoid a potential type I error when making multiple comparisons, we applied a Bonferroni correction and a more conservative significance level of P < .001. This research was exempt from 45 CFR part 46 requirements under 45 CFR 46.101(b)(4).
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