• Phillip P Salvatore, Gery P Guy, and Christina A Mikosz.
• Epidemic Intelligence Service, Centers for Disease Control and Prevention.
• Pain Med. 2022 Oct 29; 23 (11): 190819141908-1914.

ObjectiveTo identify changes in opioid prescribing across a diverse array of medical specialties after the release of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.DesignInterrupted time-series analysis of data from a commercial prescribing database.SubjectsDe-identified recipients of opioid prescriptions dispensed at U.S. retail pharmacies between 2015 and 2019.MethodsOpioid dispensing data were obtained from the IQVIA Longitudinal Prescription (LRx) database, representing more than 800 million opioid prescriptions. Monthly dispensing rates, dosage in morphine milligram equivalents (MME), and mean prescription duration were calculated across 29 medical specialties. Changes in dispensing after the release of the 2016 CDC Guideline were assessed through interrupted time-series analysis.ResultsDeclining trends in opioid dispensing accelerated in 24 of 29 specialty groups after the release of the CDC Guideline (P < 0.05 for 15 groups). Decreases were greatest among family medicine clinicians, where declines accelerated by 4.4 prescriptions per month per 100,000 persons (P = 0.005), and surgeons, where declines accelerated by 3.6 prescriptions per month per 100,000 (P = 0.003).ConclusionsThese results illustrate that clinicians likely to provide primary care exhibited the greatest decreases in opioid dispensing. However, specialties outside the scope of the CDC Guideline (e.g., surgery) also exhibited accelerated decreases in prescribing. These declines illustrate that specialties beyond primary care could have interest in evaluating opioid prescribing practices, supporting the importance of specialty-specific guidance that balances the individualized risks and benefits of opioids and the role of non-opioid treatments.Published by Oxford University Press on behalf of the American Academy of Pain Medicine.

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