Emergency physicians prescribe less than 5% of all opiate prescriptions in the United States.  Furthermore, emergency physicians had the highest decrease (-8.9%) of all medical specialties in opiate  prescriptions from 2010-2012.   Although there is an opioid epidemic, the data shows that emergency physicians are part of the solution.

FDA narcotic rx by specialty - EM less than 2percent on Long Action Opiods

Overall, opiate prescriptions increased by 11.7% from 2007 until 2012 to 289 million prescriptions.  The good news is that the numbers are starting to level off after 2010.  Still the rate for opiate prescribing was highest for pain medicine, surgery and physical medicine and rehabilitation.  Despite decreases in prescribing rates for emergency medicine, the specialties of pain medicine, family practice, general practice, and internal medicine increased their number of opiate prescriptions greater than the average of all prescribers.   After 2010, only two specialties (internal medicine and pain medicine) increased their prescribing of opiates.

In 2012 emergency physicians prescribed 60.5 Million prescriptions and 12.5 million of those prescriptions were for opiates.

Opiates by specialty

Clearly, the opiate abuse epidemic has many causes.  With regards to the medical side, we need the focus to be where the problem lies and that is with the specialties that continue to increase their prescriptions of chronic pain medications.  Certainly, the proliferation of prescription drug monitoring programs (PDMPs) will help providers make sure they are aware of all the prescription their patients are getting.  The medical community needs to look at alternative ways of treating chronic pain other than prescribing opiates.   So what else can be done?

Continue to monitor prescribing behaviors.

Increase the use of PDMPs and make them easier to use.

Expand the use of non-opioid treatment medications and modalities.

Remove pain as a vital sign.

Decrease the use of satisfaction surveys which ask patients about well the doctor dealt with their pain.

Minimize the use of long acting opiate pain medications.

Foil wrap and barcode all opioids so that they are tracked from manufacturer to patient


Source: Trends in Opioid Analgesic–Prescribing Rates by Specialty, U.S., 2007–2012 (PDF Download Available)