Over 30 percent Medicare beneficiaries consult multiple doctors for painkillers

The researchers at the Harvard Medical School has found that one out three Medicare beneficiaries have multiple doctors who prescribe them painkillers under its Part D program.

The US researchers say receiving painkiller prescription from multiple providers raises the risk of injury and invites several diseases for you.

The study found that over 30 percent people had prescription from more than one doctor. According to the study, 23.1 per cent of them had two providers, another 9.5 per cent had three providers and another 7.9 per cent had four or more providers to prescribe them painkillers.

BootsUK-pharmacy

The researchers analyzed the sample of 20 percent of subscribers to Medicare’s prescription benefit, or Medicare Part D, from 2010, including 1.8 million beneficiaries who filled at least one opioid prescription that year. They found many who refer to multiple providers for painkillers.

“The results were shocking as I thought it would be 5 to 10 percent. But when we ran the numbers, it turned out to be 30 percent,” , said study author Anupam Jena, who is an assistant professor at Harvard Medical School and a physician at Massachusetts General Hospital.

Experts say getting painkillers from more than one doctor have several health related complications. It increases the risk of respiratory depression, drowsiness and other complications, including injuries caused by falling.

The statistics show prescriptions for opioid painkillers in the United States have nearly tripled to over 200 million per year in the past two decades. Opioids like hydrocodone with acetaminophen (Vicodin), oxycodone with acetaminophen, tramadol, oxycodone, morphine sulfate, and fentanyl were commonly prescribed by the doctors. Long term use of prescription opioids among adults 65 or older increased from 5 per cent of patients in 1997 to 9 per cent in 2005.

The researchers also found a link between the number of prescribers for a patient and the patient’s risk of getting hospitalized.

The study was published in the British Medical Journal.

  • llewellynh

    Try this. I have a serious fistula and that surgeon gives my husband an Rx for pain which I will be in for a good week when I wake up and return home.

    My cardiologist needs to do an angioplasty and later in the year gives me a few pain killers to get through the first day or so.

    I have a torn rotator cuff at a another point in time in the same year, and my orthopedic surgeon gives me a pain killer.

    None of these pills are for the same medicine and I certainly don’t get more pills than I need for a few days.

    Now let’s see the government make one big logarithm about this. Or should I move to a state that sells pot. Much easier. Or stay where I am and drink booze.

    • rokidtoo

      I’m convinced. Anyone who uses the word “logarithm” in a sentence has got to be way smarter than those silly Harvard medical researchers.

      Of course, you might want to use “algorithm” in your next rant. Did someone on Fox use the word “logarithm”?

      • jbs56

        Llewellynh is precisely correct in terms of the common sense interpretation of this. This is propaganda being over-interpreted by drug war doomsdayers. It is true only a miniscule minority of people would actually get enough pain meds to do any damage, even if they get small amounts from 10 doctors. There are also all kinds of perfectly good reasons people would get multiple prescriptions. The author’s interpretation of this is hype. It is actually demonstrably flawed for all the reasons knowledgeable people on this discussion have enumerated. And, by the way, aside from the fact that the researchers probably did use a logarithm to make something normal look like a ’10 football field size asteroid’ making a close pass to our baby blue, llewellynh’s sarcastic use of the term in that way was fairly stimulating, I thought — certainly not characteristic of ignorance — which you don’t have to look too far in this thread to find. Pain med phobia is big business in the press right now, having recently received a few shots in the arm from an angry drug war bureaucracy, and the temptation to overstate the case is just irresistible to those who have a deadline. It buys gas and groceries!

        • rokidtoo

          Could you provide a link to your exhaustive study of this issue?

          • jbs56

            I could provide you with a lot of literature, but I didn’t refer to any study here. I referred to common sense, and I gave opinions and discussed the use of the term “logarithm,” as it seemed to me the author was being intellectually bullied for what was not bad writing. This is not the proper forum for the debate, although I realize that is a deferral to your point of view by default. If you are interested in informed literature (including interpretation of quantitative findings) about drug addiction and drug war policy, I suggest you start with an author search: Stanton Peele. That will lead you to others, and to a vast literature which challenges traditional American views on the topic. And yes, my study of the pain med issue is less than exhaustive, but it is focused and quite advanced.

    • dale ruff

      Such serial pathologies would not account for 30% of Medicare beneficiaries getting multiple prescriptions, would it?

      I suggest you move to Colorado.

  • David Anderson

    This is baloney. Look at the dates of the study, it is pre-AHCA. You can no longer doctor-shop for multiple scripts like this, it’s all recorded under a singular online record. The days of cowboy medicine are gone now.

    • NancyN

      Good observation, great catch! The article confused me too because DEA databases showing the prescriptions filled are accessible by doctors now, and they would validate why a patient had multiple prescriptions, such as with the good examples in these comments. Upon investigation, if the patient’s reason was not valid, the patient would be flagged.

    • tempf451

      thank you ,just what i was thinking

  • Harry Covington

    It’s called the war on patients. I was put in permanent disability seven years ago because of numerous and painful problems. My Doctor refuses to prescibe more than HALF the amount allowed. Because opiate tolerance affects all that have to take them long term, I am in pain all the time. The Mayo Clinic wrote an article several years ago reminding Doctors that controlling pain is a major part of their job, and if they refuse to use the proper opiates to accomplish that, they should find another line of work. It is all absurd. The number one cause of emergency room visits and death each year are from acetaminophen 78,000 – 12,000, not prescription pain meds. We can thank the DEA for leaving millions of people to suffer without relief because a few abuse them.

    • dale ruff

      Why don’t you change doctor’s? If your doctor is ignorant, why have you not found a new doctor long ago? You are in pain all the time, you state. And yet you do not find a new doctor who will treat your pain adequately? It seems absurd to complain and do nothing.

      • Harry Covington

        What is absurd is your idiotic assumption that I have not seen several Doctors allowed by my insurance. ALL are trained in India and have little knowledge of pain control or the medicine they prescribe.

        • dale ruff

          Your insulting post implies that you are unable to find a doctor (not trained in India) who will prescribe adequate pain medication.

          Goodness, Harry, there are a million doctors who will prescribe pain medication. The idea that there are none is puzzling.

          PS. Lay off the insults. It makes you look bad.

          • Harry Covington

            Uh moron…I don’t have access to millions of Doctors. You obviously know nothing about insurance companies and the limited Doctors available under the plan, but that doesn’t stop you from running you mouth. If you don’t care to be insulted, stop making stupid and uniformed remarks.

          • dale ruff

            I apologize. I am a moron for suggesting that it’s not that hard to find a doctor who will prescribe pain medication or who is not Indian.

            Who is your insurer who won’t allow you to find a doctor who will follow the professional mandate to provide adequate pain relief?

            Do you want help or do you want to suffer?
            Your insults are very sad since I am trying to help you.

            What insurance company only hires Indian doctors who won’t treat pain? We will help you protest. We can sign petitions.

            What is your goal posting here? Is it not to find help?

    • nhr215

      That’s ridiculous. Its basically legal heroine. And the doctors have addicted people to it. There are other solutions to pain control. Most of the pain control is really addiction behavior. People survived with chronic pain for centuries without being hopped up on insane doses of opiates. This is the number one drug problem in the country! You should go to rehab and taper off of it.

      • Daniel122

        Just because opiates were not in your history books does not mean they were not used. Fact: opiates have been a staple in chinese and middle eastern culture for thousands of years and were commonly available through major trade routes and were used throughout the world for a very long time. Dont let historical censorship misguide the way you think the world was, is or should be.

      • wlingua

        Yes and those that could not deal with their pain either killed themselves or became hopeless alcoholics. So let’s ban alcohol as well America’s real drug of choice.

      • Harry Covington

        Legal heroine? Really? All your comment shows is that you are as dumb as a rock. Why don’t you write about subjects you actually know something about, maybe video games or Saturday morning cartoons.

    • JimmySD

      Harry,

      You are an addict. Go to detox.

      After you get out learn to suck it up, walk it off, and not be such a baby.

      It would also help if you lost some weight instead of living like lazy grease eating white trash.

      • Harry Covington

        Ah yes…no discussion is complete without a few words from the morons. Yours is particularly special in that regard. It contains no relevant information to the subject or my comment. It is childish to the point I had to ask what a 10 year old is doing on this site. Then I remembered….some people NEVER grow up.

  • taxedmore

    Get multiple prescriptions filled and then sell it for 100% profit. The liberals say the taxpayers are supposed to pay for as much free stuff as anybody wants. And that’s just what the stupid taxpayers do – year after year after year…….

    • Interrupting ReplyBot 2012.1

      Yeah, those stupid taxpayers, who are on Medicare. Damn liberal agenda. The gubment should keeps it’s hands off of my Medicare!

  • Barbara R.

    I truly believe that the solution to this issue is the use of a pain management doctor. Yes it’s additional costs to patients but the savings in “doctor shopping” is worth it. If I have to see an ER doctor for a fall, He prescribes a pain killer and I report it to my pain management doctor. Works well for me…hope it would work for others.

    • NorCal Native

      My wife’s “pain management doctor” [sic] is a quack. I nailed him, and had him on a lawsuit if he failed to back down (he backed down quick after a certified letter). Most “pain management doctors” are loony “mind over matter” types (just “wish it” away) that ASSume all people with chronic pain are “drug seekers” until “proven” otherwise.

      • freshstart222

        My pain management doctor didn’t even bother to examine me and just wanted to be paid.

        • NorCal Native

          That’s exactly what happened with my wife. He put down “diagnoses” that required proper examination of body and records, yet did not conduct such examinations. I forced him to retract his false “diagnoses” under threat of lawsuit. Patients are just numbers, both medical record numbers and especially billing codes, to most “doctors.”

          • Barbara R.

            I’m sorry. I know I received a thorough examination during our first visit. I’m really sorry you had that experience. It shouldn’t have happened that way.

        • Barbara R.

          I’m sorry. I know I received a thorough examination during our first visit. I’m really sorry you had that experience.

      • nhr215

        Chronic pain sufferers on opiates ARE drug seekers. They ade addicts. That is why physicians who are specialists in pain are trying to get them off of it. There are other methods. People lived without opiates before….

        The first step is to admit you are an addict.

        • Daniel122

          What people lived without opiates? They have been around for hundreds of years and have been heavily regulated for only the last sixty years.

          • NorCal Native

            Marijuana, opium, and coca, among others, have been used for pain for millennia. The Pharmacide Industry can’t patent them, so they continue to be “illegal” except for the latter two when issued by “legal” drug dealers…and the Pharmacide Industry would like to see THEM curtailed now, since they’re cheap, compared to the deadly garbage that makes the bulk of their money.

        • Harry Covington

          Yep, that’s the ticket. Why have Doctors at all…or cars, or planes, We should all just live in caves. The first step is to admit you are an imbecile.

        • NorCal Native

          “Pain specialists” who take away pain relievers are specialists in INFLICTING pain in accordance with some committee’s edict.

          I’m sorry you are an addict of stupidity.

        • Barbara R.

          I am not an addict. I AM dependent. There is a difference in that I regularly go off my meds and I’m very sorry each time I have. The pain level goes above 10, no symptoms of withdrawal ie, cramps, etc. BTW Can you tell me where you get your information that ALL chronic pain sufferers on opiates are drug seekers/addicts? I believe we are addicted to having our pain relieved. Most chronic pain sufferers must endure extremely painful tests to determine whether they should continue on opiates or not and this is even after getting injections into lower back and other extremities to relieve pain.

      • Barbara R.

        I’m sorry you had that experience. It wasn’t and isn’t mine.

  • Thomas

    Pain killers are for pussy’s and pill popping addicts.

    • Interrupting ReplyBot 2012.1

      My friend, karma is a boomerang. Someday you’ll find that out, the hard way.

      • Harry Covington

        Right! It would be nice to see these fools have multiple breaks in their legs, permanent spine damage, frozen shoulder on both sides, and then given an aspirin and told to suck it up. They would be crying like the babies they are.

    • NorCal Native

      As you down yet another “cold one,” right?

  • Vernon Yost

    Can’t recall the last time I was prescribed an Opioid. Long before I retired.
    Now my sister, who passed a couple of months ago, had them just given to her as if they were Vitamin C tablets as well as my brother in law. When you hit a certain age, they want your system to just shut down. She even had the Fentanyl patch to quicken things along. One needs to age with their eyes wide open

    • NorCal Native

      Last time for me was 2006; made me angry, so I stopped taking them.

  • NorCal Native

    You go to the dentist and have a tooth pulled: one opiate. You go to the orthopedist for chronic osteoarthritis: another opiate. BOOM – you’re getting multiple opiates from multiple doctors.

    Personally, Ibuprofen is enough for me. But – some people are much less tolerant to pain than I, and, some people are allergic to NSAIDs. No one should suffer enduring pain because government bureaucrats (“doctors” of the Faster Death Administration) and their “academic” minions claim people are taking “too many” painkillers.

  • Robert Warner

    You have to go to different specialists for different afflictions as one ages. Our national health care problem is relying on state controlled, good old boy “private” insurance companies to determine provider, rate, and hospital compensation – all compartmentalized so that sharing of information is limited, if existing at all. Medicare is the best of all solutions historically validated. The program negotiates, based on statistical volume, decent procedural rates, contract clauses (about information sharing, for one), and guarantee no hidden charges for the American patient who qualifies. Negotiation. Negotiation. Negotiation. Maybe from an equal negotiating position?. No wonder private, state centered monopoly insurers hate it.

    • NorCal Native

      Medicare for All was what was needed; instead, we got corporation-friendly Obama”care”.

      • Robert Warner

        Yep. Small steps first. Do you really want a Ukraine situation here?

      • pierider

        Dems wanted single payer, repugs insisted on romneycare lite writ large.

    • dale ruff

      Except for drugs, which by law (Bush 2003 Part D) Medicare is prohibited from negotiating prices so must pay whatever the profit-driven drug companies state is the retail price (always highly inflated).

      Medicaid and the VA do negotiate and get much lower prices.

      This law, which was presented as a boon to seniors, is in fact a giveaway of tens of billions to wealthy drug corporations (Medicare has 50 million clients but can’t do volume purchasing, in opposition to the free market principles avowed by the Republicans who passed this absurd law which has 2 vile purposes:

      1) to transfer billions in Medicare money to drug companies

      2)to bankrupt Medicare so it can be replaced with a totally private system.

      A 2008 Congressional study found:

      “This report uses confidential information on drug prices to compare the costs of drugs purchased under the new Medicare Part D program with the costs of drugs purchased under traditional Medicaid. It finds (1) that Medicare Part D pays on average 30% more for drugs than does

      Medicaid and (2) that this discrepancy in pricing produced a windfall worth over $3.7 billion for drug manufacturers in the first two years of the Medicare Part D program.

      That report found

      that the administrative expenses and profits of the private insurers accounted for nearly 10% of

      the costs of Medicare Part D, nearly six times as much as the administrative expenses of

      traditional Medicare”

      Also, to show the inefficiency and greater cost of privatization of Medicare, Medicare Part A (govt part) has an overhead of 2% whereas Part B (private insurance) has an overhead of 11%.

      Overall, private insurance has an overhead of 20%, which even under the ACA is allowed. Medicaid, like Medicare Part A, has an overhead of 2%.

      Public option anyone? How about a non-profit single payer system (which states are allowed to create) which would immediately shave 18% off the cost of healthcare and bring down premiums.?

      Medicare for All would save, in unnecessary overhead (such as the 105 million salary the United CEO got in 2009 as we all saw our equity evaporate), 500 billion a year, which is the projected deficit for next year.

      We are being ripped off! Fight back!

      • Harry Covington

        Excellent comment sir. I can hear the whooshing sound as it goes over the heads of trolls here.

  • William Skye

    Amanda, whether it is you or your editor, I would be ashamed to put my name on such a poorly written article.

    The US researchers say receiving painkiller prescription from multiple providers raises the risk of injury and invites several diseases for you.

    One problem is logical: how do painkillers “invite” diseases? Respiratory depression is not a disease. Another problem is the with the last two words: For You. For me? Or.. for you? Amanda, do you have a drug problem?

    Finally, there is the issue of what is the nature of the society in which we wish to live? A society of individual responsibility, or a society in which a minority of experts take care of the helpless majority (feel free to place double quotes liberally throughout this sentence)? Yes, some elders need special care, but the rest of us? You can have my opiates when you pry them from my… oh, never mind.

    • dale ruff

      “A disease is an acquired morbid change in any tissue characterized by symptoms whereas a disorder is a disturbance of structure due to genetic failure as a result of exogenous factors. In comparison to disorder which requires long term medical attention, a disease can be easily diagnosed as well as treated. Severity in both a disease and a disorder results in death.”

      Whether respiratory depression is called a disease, a disorder, or a condition, it appears that it can kill you and is more difficult to treat than many diseases. Your critique of the language of the researchers appears to backfire.

    • nhr215

      She is just quoting the study. Don’t blame the messenger because you don’t like the message.

      Also, respiratory depression is a cause of DEATH. It may not be a disease, but its a deadly condition caused by opiate overdose, among other things.

      Get off the legal heroine already.

  • Robert Furst

    Hooray now all of us can get mutiple perscriptions for painkillers even those of us who pay for insurance since now the same morons will be processing our claims

  • Brian Johnson

    maybe the rewrite of the story by Amanda Pierce left out some nuances of the original study that has made the commenters appear to be folks with drug seeking tendencies “Patients with four or more prescribers were twice as likely to be hospitalized for narcotics-related complications than patients receiving the same number of prescriptions from a single caregiver,” Karaca-Mandic said in the news release….. personally I’ve never given Narcan to a person that knew all the junk they had been prescribed was really going to cause them to stop breathing and see the white light…..and then where was it written that life would be easy and we were all promised a rose garden……..

  • spongeblog

    If one Dr doesnt gove, they go for a “second opinion.” America is too relient on these drugs

  • jbs56

    This latest wave of drug war hysteria has been messing up my news screen for a couple of days, and it would be laughable if it weren’t taking up good space — especially the number of journalists jumping on board. First, 30% isn’t “most.” It may look huge, until you consider it is 10% shy of even being one out of three. If that still sounds huge, then the first big illusion was successful. Population. If they are on Medicare. They are old people. Old people are often…sick. Often very sick. They often have physical problems which are both painful and resistant to timely medical solutions. The next big illusion is …you guessed it … population. Who is going to be seeing more than one doctor who would give pain meds to begin with? Maybe those who are sick — really sick– and old — and in pain? Somewhat less than one in three. Now, subtract out the emotional inflations surrounding the word “multiple,” to get down to something that really looks suspicious or dangerous, and the percentage drops precipitously. So, we have doctors (at least some proportion) who have enough compassion to be sure old people who are in pain, who are seeing multiple doctors of the type who would prescribe pain meds, get compassionate relief when they go to these doctors instead of a bunch of drug war theory. The next big illusion is even more powerful and misleading: the illusion that the people reading this know all about what opioid pain medications are and understand their dangers, but the slightly less than one in three old people in pain seeing multiple doctors in this study just don’t know all that stuff. They are as lost as children. They don’t know what a pain pill is. They will go straight home and overdose, taking all the pain pills all the doctors said because doctors knows best. Right.

    I would say this particualr wave of propaganda is not only flawed interpretation of flawed interpretation, but it insults the intelligence of the elderly.

  • wlingua

    This is flawed logic that leads to false conclusions. The study has no way of distinguishing between your personal care provider and your specialists / emergency room / hospital / hospice care providers.

    My friend, who is a retired military and former law enforcement officer, has had 3 heart attacks and been in 4 car wrecks. His primary care physician responsibly manages his incurable pain with opiates.

    When he underwent surgery to remove several teeth, his oral surgeon proscribed the needed extra opiates for that pain in coordination with his primary care physician who cannot prescribe medicine for a procedure that he did not perform.

    He recently had prostate surgery in our local hospital. The doctors at the hospital were responsible for managing his pain while he was there for 4 days. They coordinated with his primary care physician who did not issue medication for the days he was in hospital. The hospital pharmacist made sure there was no overlapping medicines prescribed.

    His dermatologist removed several cancerous growths and a specialist removed a dangerous growth near a nerve in his hand. The first did not issue extra pain medicine for that procedure after consulting with his primary care physician, the second doctor prescribed 24 hours worth of pain medicine after consulting with his primary care physician.

    In short, many doctors provided opiates to him for different reasons at different times. In no case was he over-proscribed medicine, his physicians coordinated with to provide what was needed and only for the times it was needed.

    How do I know these things? I take him to all his doctors and participate in helping them coordinate his needs. His power of attorney for healthcare designates me as the responsible party for healthcare decisions when he is unable to make those decisions for himself.

    So to take that data blindly, not knowing the situations that gave rise to the prescriptions, you might surmise that he is a pill-popping addict who shops around for as many narcotics as he can get.

    The uninformed conclusion jumpers who often comment on such matters would brand him a drug dealer who sells his extra pills on the street making thousands of dollars a year from medicine we pay for. And nothing would be further from the truth.

    My 87 year-old father, my mother, my oldest sister, have all been proscribed opiate pain killers for legitimate reasons by multiple providers during the year.

    None of them were “shopping for pain killers” and I assure you none of them would even consider selling prescription drugs to drug addicts. And none of them were over-prescribed or prescribed over-lapping medicines. And yet, like him, this study would count them in this mythical 30 percent of abusers.

    Yes, there is an enormous prescription drug problem in this country. And yes, people do abuse the system. But whenever a solution seeking to coordinate drug care is proposed, people go nuts because the government is taking over their healthcare, our privacy is being invaded, you can’t trust the government with that information, and the ever-present if the other political party proposes it I will not support it arguments resurface.

    The solution is not to overly restrict physicians who are in the best position to know what their patients need but to insure that physicians, specialists, hospitals, pharmacists and insurance companies coordinate with each other in providing the needed care.

    Certainly some guidelines are in order, some regulation is necessary to catch those that would abuse the system. But denying needed medicines to those that truly need it in a one-shoe-fits-all manner is not an answer to the problematic few.