Direct-to-physician marketing of opioids leads to doctors prescribing more opioids, which results in more overdoses and deaths, according to a new JAMA Network report.
The study found that counties with doctors that received more opioid-related marketing saw higher opioid-overdose deaths.
The researchers used data from CMS’ Open Payments database and CDC’s opioid prescribing and mortality from overdoses data. Between Aug. 1, 2013 and Dec. 31, 2015, there were nearly 435,000 payments that totaled almost $40 million in nonresearch-based opioid marketing sent to 67,507 physicians across 2,208 counties.
Opioid overdoses and deaths remain a problem in the U.S. Prescription opioids contribute to more than 17,000 overdose deaths annually as opioid prescriptions skyrocketed over the past two decades. The CDC said that overdose deaths increased by 200% between 1999 and 2014 and another 28% between 2015 and 2016 alone.
The JAMA report said 40% of all opioid overdose deaths in the U.S. are connected to prescriptions. Also, the first opioids usually taken by people with opioid use disorder are prescription drugs.
Physician prescribers are a frequent source of prescription opioids for people who take the drugs recreationally. Opioid prescribing has decreased this decade, but it’s still three times higher than in 1999 and the decrease isn’t as rapid in areas with more opioid-overdose deaths, the report said.
Payers and providers are working on multiple efforts to reduce opioid prescriptions and get addicted people help. One way is using social determinants of health data to flag those at greatest risk of abuse. Multiple payers have also created programs and set goals to reduce opioid prescriptions. That effort includes moving people to other types of pain management.
The American Medical Association backs medication-assisted treatment as a way to confront the problem. MAT utilizes medications, counseling and behavioral therapies.
Federal leaders are also involved in fighting the epidemic. Last year, President Donald Trump signed a bipartisan law that expanded access to treatment for opioid misuse, provided funding for research on non-addictive pain management and offered greater enforcement for those dealing in opioids.
In the new JAMA report, researchers, led by Scott Hadland at the Grayken Center for Addiction at Boston Medical Center, explored the connection between opioid marketing and prescriptions. In looking at the link between opioid marketing and prescriptions, the researchers said one in 12 U.S. physicians (and one in five family doctors) released marketing related to opioids between 2013 and 2015.
The study discovered counties that received more opioid-related marketing saw higher opioid-overdose deaths. Despite efforts to reverse the opioid prescription and death trend, the researchers suggested that the millions of dollars spent on direct-to-physician marketing might be working against those efforts.
"Our findings suggest that direct-to-physician opioid marketing may counter current national efforts to reduce the number of opioids prescribed and that policymakers might consider limits on these activities as part of a robust, evidence-based response to the opioid overdose epidemic in the United States," they wrote.