Opioid Prescription Practices of Neurosurgeons in the United States: An Analysis of the Medicare Database, 2013-2017

Abstract

Abstract BACKGROUND Opioids are a highly effective yet potentially addictive tool in postsurgical pain management. Neurosurgical prescribing patterns should be continually monitored to assure optimal use of these drugs. OBJECTIVE To characterize the number of prescriptions written by neurosurgeons for the most commonly prescribed opioids and to assess the geographic trends and quantify the length of prescriptions and number of Medicare beneficiaries receiving opioids during the study period. METHODS The Medicare Part D database was queried to determine the most common opioids prescribed by neurosurgeons from 2013 to 2017. The number of prescriptions, mean length of prescriptions, and number of beneficiaries were tabulated by geographical region of practice. RESULTS The number of opioid prescriptions in the US decreased by 28.4%, from 379 346 in 2013 to 271 738 in 2017. This trend was observed across all geographical regions. The South had the highest number of prescriptions and smallest percent change of all regions, from 217 431 in 2013 to 164 495 in 2017 (−24.3%). The mean length of prescription increased slightly, from 16.0 d in 2013 to 17.3 d in 2017 (8.0%). The number of beneficiaries receiving opioids increased by 33.0% during the study period, from 174 491 in 2013 to 232 055 in 2017. The number of beneficiaries ≥65 yr increased 45.5%, from 53 596 in 2013 to 77 976 in 2017. CONCLUSION Although more people are receiving opioids, the total number of prescriptions is decreasing. This decrease may reflect a decrease in the abuse of these drugs and the success of prescription drug monitoring programs.