Department of Economics, Finance, and Quantitative Analysis, Samford University, Birmingham, AL, USA.
Department of Child and Adolescent Psychiatry, University of Washington, Seattle, WA, USA.
Trends Psychiatry Psychother. 2020 Jan-Mar;42(1):48-54. doi: 10.1590/2237-6089-2019-0015.
The opioid epidemic is a severe problem in the world, especially in the United States, where prescription opioid overdose accounts for a quarter of drug overdose deaths.
To describe psychiatrists' prescription of opioid, benzodiazepine, and buprenorphine in the United States.
We conducted a retrospective cross-sectional study of the 2016 Medicare Part D claims data and analyzed psychiatrists' prescriptions of: 1) opioids; 2) benzodiazepines, whose concurrent prescription with opioids can cause overdose death; 3) buprenorphine, a partial opioid agonist for treating opioid addiction; 4) and naltrexone microsphere, a once-monthly injectable opioid antagonist to prevent relapse to opioid dependence. Prescribers with 11 or more claims were included in the analysis.
In Medicare Part D in 2016, there were a total of 1,131,550 prescribers accounting for 1,480,972,766 total prescriptions and 78,145,305 opioid prescriptions, including 25,528 psychiatrists (2.6% of all prescribers) accounting for 44,684,504 total prescriptions (3.0% of all prescriptions) and 131,115 opioid prescriptions (0.2% of all opioid prescriptions). Psychiatrists accounted for 17.3% of benzodiazepine, 16.3% of buprenorphine, and 33.4% of naltrexone microsphere prescriptions. The opioid prescription rate of psychiatrists was much lower than that of all prescribers (0.3 vs 5.3%). The buprenorphine prescription rate of psychiatrists was much higher than that of all prescribers (2.3 vs. 0.1%). There was a substantial geographical variation across the United States.
The results show that, proportionally, psychiatrists have lower rates of opioid prescription and higher rates of benzodiazepine and buprenorphine prescription.
阿片类药物泛滥是全球面临的严峻问题，尤其是在美国，处方类阿片类药物的过量使用导致了四分之一的药物过量死亡。
描述美国精神病医生开具阿片类药物、苯二氮䓬类药物和丁丙诺啡的情况。
我们对 2016 年医疗保险 D 部分索赔数据进行了回顾性横断面研究，并分析了精神病医生的以下处方情况：1）阿片类药物；2）苯二氮䓬类药物，与阿片类药物同时使用会导致过量死亡；3）丁丙诺啡，一种用于治疗阿片类药物成瘾的部分阿片类激动剂；4）纳曲酮微球，一种每月一次的可注射性阿片类拮抗剂，可预防阿片类药物依赖的复发。纳入分析的处方医生至少开具了 11 份处方。
2016 年，医疗保险 D 部分共有 1131550 名处方医生开具了 1480972766 份总处方和 78145305 份阿片类药物处方，其中包括 25528 名精神病医生（占所有处方医生的 2.6%）开具了 44684504 份总处方（占所有处方的 3.0%）和 131115 份阿片类药物处方（占所有阿片类药物处方的 0.2%）。精神病医生开具的苯二氮䓬类药物处方占 17.3%，丁丙诺啡处方占 16.3%，纳曲酮微球处方占 33.4%。精神病医生开具阿片类药物处方的比例明显低于所有处方医生（0.3%比 5.3%）。精神病医生开具丁丙诺啡处方的比例明显高于所有处方医生（2.3%比 0.1%）。美国各地存在显著的地域差异。
结果表明，与所有处方医生相比，精神病医生开具阿片类药物处方的比例较低，而开具苯二氮䓬类药物和丁丙诺啡处方的比例较高。
