ArticlePharmacoepidemiology and drug safety2014
The ecology of prescription opioid abuse in the USA: geographic variation in patients' use of multiple prescribers ("doctor shopping").
Article in Pharmacoepidemiology and drug safety, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Exploring Opioid Prescription Patterns and Overdose Rates in South Carolina (2017-2021): Insights into Rising Deaths in High-Risk Areas.Healthcare (Basel, Switzerland) · 2024Article
- Concordance of opioid exposure in all-payer claims databases with prescription drug monitoring program database using Arkansas as a case example.Health services research · 2023Article
- Does electronic prescribing of controlled substances deter controlled substance prescribing in emergency departments?Heliyon · 2023Article
- Adaptive interventions for opioid prescription management and consumption monitoring.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Comparing measures of centrality in bipartite patient-prescriber networks: A study of drug seeking for opioid analgesics.PloS one · 2022Article
- Prescribing Associated with High-Risk Opioid Exposures Among Non-cancer Chronic Users of Opioid Analgesics: a Social Network Analysis.Journal of general internal medicine · 2019Article
- Impact of a prescription drug monitoring program use mandate on potentially problematic patterns of opioid analgesic prescriptions in New York City.Pharmacoepidemiology and drug safety · 2019Article
- Network Abstractions of Prescription Patterns in a Medicaid Population.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2019Article
- Characteristics of doctor-shoppers: a systematic literature review.Journal of market access & health policy · 2019Article
- Visualizing nationwide variation in medicare Part D prescribing patterns.BMC medical informatics and decision making · 2018Article
- Association of Chronic Opioid Use With Presidential Voting Patterns in US Counties in 2016.JAMA network open · 2018Article
- Association of Household Opioid Availability and Prescription Opioid Initiation Among Household Members.JAMA internal medicine · 2018Article
- Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis.BMJ (Clinical research ed.) · 2017Article
- National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment.American journal of public health · 2015Article
- Assessing Spatial Relationships between Prescription Drugs, Race, and Overdose in New York State from 2013 to 2015.Journal of psychoactive drugsArticle
- Identifying sociodemographic profiles of veterans at risk for high-dose opioid prescribing using classification and regression trees.Journal of opioid managementArticle
Corrections and comments
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Authors and funding
2 authors.
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Abstract
purposeThis study estimates the prevalence in US counties of opioid patients who use large numbers of prescribers, the amounts of opioids they obtain, and the extent to which their prevalence is predicted by ecological attributes of counties, including general medical exposure to opioids.
methodsFinite mixture models were used to estimate the size of an outlier subpopulation of patients with suspiciously large numbers of prescribers (probable doctor shoppers), using a sample of 146 million opioid prescriptions dispensed during 2008. Ordinary least squares regression models of county-level shopper rates included independent variables measuring ecological attributes of counties, including rates of patients prescribed opioids, socioeconomic characteristics of the resident population, supply of physicians, and measures of healthcare service utilization.
resultsThe prevalence of shoppers varied widely by county, with rates ranging between 0.6 and 2.5 per 1000 residents. Shopper prevalence was strongly correlated with opioid prescribing for the general population, accounting for 30% of observed county variation in shopper prevalence, after adjusting for physician supply, emergency department visits, in-patient hospital days, poverty rates, percent of county residents living in urban areas, and racial/ethnic composition of resident populations. Approximately 30% of shoppers obtained prescriptions in multiple states.
conclusionsThe correlation between prevalence of doctor shoppers and opioid patients in a county could indicate either that easy access to legitimate medical treatment raises the risk of abuse or that drug abusers take advantage of greater opportunities in places where access is easy. Approaches to preventing excessive use of different prescribers are discussed.
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