Letters to doctors reduce opioid prescriptions, study shows

In order to conduct the study, researchers involved used a database of 861 healthcare professionals who had prescribed opioids and other risky medications to those who had subsequently died of overdoses involving prescription medicines. More than 400 of those professionals listed on the database were sent so-called ‘Dear Doctor’ letters, through which they were informed that their patients had died of overdoses.

The letters opened in stating that: "This is a courtesy communication to inform you that your patient (name, date of birth) died on (date). Prescription drug overdose was either the primary cause of death or contributed to the death." They continued to offer guidance as to how to safely prescribe medicines that carried the potential for fatalities.

Researchers then tracked the prescribing behaviour of those doctors who received the letters over a three month period. Those who had received the letters reduced the total amount of opioids –measured in morphine milligram equivalents- that they prescribed by an average of 10%, in comparison to those who did not receive the ‘Dear Doctor’ letters at all. Letter recipients also wrote fewer opioid prescriptions for new patients.

"It's a powerful thing to learn," said Jason Doctor, a Public Policy Researcher at the University of Southern California, who led the study. Study co-author Dr. Roneet Lev, chief of emergency medicine at Scripps Mercy Hospital in San Diego was also surprised to find her own name among those who had prescribed drugs to people who had later died of an overdose of prescription medicines.

It was noted that Lev had prescribed 15 opioid pain pills to an individual with a broken eye socket. However she was unaware that the patient had received 300 pain killer pills from a doctor just a day earlier.  

Although the number of opioid prescriptions has fallen in recent years, deaths continue to rise. Nearly 48,000 Americans died of opioid overdoses last year as fentanyl surpassed prescription pain killers and heroin as the most fatal opioid drug. However it is hoped that by reducing the number of prescriptions the path towards illegal opioids such as fentanyl will become increasingly more difficult to follow.

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