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The BMJ reports that while most US providers are cautious in their prescribing, half of opioid prescriptions are written by 1% of providers.
Between 2003 and 2017, there was an annual average of 669495 providers prescribing 8.9 million opioid prescriptions.
In 2017, 1% of providers accounted for 49% of all opioid doses and 27% of all opioid prescriptions; that's nearly 1000 times more than the middle 1% of prescribers.
Providers prescribing high amounts of opioids and patients receiving high amounts of opioids persisted over time, with over half of both appearing in adjacent years.
The authors believe that interventions to reduce inappropriate opioid prescribing should be focused on improving patient care, management of patients with complex pain, and reducing comorbidities rather than seeking to enforce a threshold.