A new study from Melissa McPheeters, PhD, MPH, research professor of health policy, finds that “prescribing (opioids) is common in Tennessee before an overdose, does not decrease appreciably afterward, and MAT may be underutilized as increases in buprenorphine were not observed after overdose events.”
The study, published in the journal “Preventive Medicine” analyzes patient discharge data and prescription drug monitoring program (PDMP) data from 2013 to 2016. This is the first known study in Tennessee to “evaluate the change the in dispensing of (controlled substances) around all drug, opioid, and heroin non-fatal overdoses using PDMP data.”
The study finds that prescription of opioids did not decrease appreciably following an opioid overdose.
Fills of controlled substances after the overdose decreased, but the study notes that "patients generally continue to receive prescription opioid analgesics after an overdose, with limited uptake of buprenorphine for MAT, which is the primary medical approach available in Tennessee for treating substance use disorder.”
The researchers did not have access to data on the clinical indication for the opioids prescribed and it is likely the prescriber would have been unaware of the overdose that the patient experienced. This may represent a missed opportunity for counseling on appropriate opiate use or for identifying substance use disorder.
But as the study also notes Tennessee “does not have a statewide health information exchange and it is likely that clinicians re-prescribing to patients who experienced an overdose may be completely unaware that the overdose occurred.
It’s also notable that there is no established system to routinely notify primary care providers after an ED or inpatient visit for an overdose.”
Read the full study in Preventive Medicine here: https://www.sciencedirect.com/science/article/pii/S0091743519303597?dgcid=author