An analysis of the number of multiple prescribers for opioids utilizing data from the California Prescription Monitoring Program.

BACKGROUND

Prescription monitoring programs scrutinize the prescribing of controlled substances to diminish the utilization of multiple prescribers (aka. "doctor shopping"). The use of multiple prescribers is not a problem per se and can be legitimate, as when the patient's regular physician is not available or a concurrent painful condition is being cared for by a different practitioner.

PURPOSE

The primary objective of this study was to determine if those patients who used a few prescribers (two to five) in a 1-year period were distinguishable from those who used only one prescriber.

METHODS

We performed a secondary data analysis of the California Prescription Monitoring Program, the Controlled Substance Utilization Review and Evaluation System, by using data collected during 1999-2007.

RESULTS

The group who used a few providers (two to five) differed substantially from those who visited one provider over a 1-year period. However, the dissimilarity did not suggest that these patients were more prone to the abuse of opioids.

CONCLUSIONS

The decision not to investigate patients who visit a low number of multiple prescribers (two to five) appears to be justifiable. If the number of providers in a given period of time is used to determine if a patient should be challenged as being a "doctor shopper," cutoffs with high specificity (low false-positive rates) should be chosen. Further epidemiologic research is needed to determine the association of the number of prescribers and misuse and/or abuse of opioids.