Tennessee Painkiller Prescriptions Drop By 15 Percent Since Doctor-Shopping Crackdown

WPLN | By Blake Farmer,

Blake Farmer

Published January 4, 2016 at 6:09 AM CST

In 2012, Tennessee began requiring doctors to check a database before prescibing high-powered narcotics to patients. Most states have a similar prescription database, though fewer states mandate doctors to check it.

Tennessee doctors are prescribing far fewer high-powered narcotics than they were just a few years ago. State health officials believe that’s partly because physicians are now required to notify the state when they put patients on a regimen of painkillers.

Since 2012, the amount of opiates like oxycodone and hydrocodone prescribed in Tennessee has dropped by about 15 percent or roughly a billion milligrams.

"I think there's been a lot of factors that have been responsible," says David Reagan, who is Tennessee's chief medical officer. "It's really the attention of everyone being willing to say, 'hey, we've got a problem here.'"

The database that’s tracking the drugs has been around for more than a decade, but not until 2012 were doctors required to use it. By logging in, they know if a patient is already getting drugs from another prescriber and how many pharmacies they've visited recently.

A third of physicians using the database told the state through a survey that they were now more likely to refer a patient to addiction treatment.

And the state knows which physicians are the heaviest prescribers, though the names are kept confidential. Tennessee’s chief medical officer — David Reagan — says there’s reason to shield doctors from public scrutiny.

“Some of them simply have busy practices and they’re doing a good job; and what they do is pain medicine. So by making a list like that public, it would create misconceptions in the public’s mind about individual practices that would be inappropriate.”

While the state won’t disclose the doctors doing the most prescribing, it is showing the counties where the most pain pills are sold through pharmacies. There’s been a big year-over-year decrease in parts of Northeast Tennessee, which has had the biggest problem with pain pills in recent years. But rural parts of the Cumberland Plateau and along the Tennessee River have seen a spike in the last year.

"We’re seeing parts of the state—that have not historically had to worry about this epidemic—worsening in a number of measures more rapidly than we’re seeing anywhere else in the state," Reagan says. "And we’re seeing the most hard-hit parts of the state improving substantially."

MME stands for "morphine milligram equivalent." This county-by-county map shows in red where prescriptions have gone up, not down.

While prescriptions are down statewide, overdose deaths have not yet peaked.

The official figures for 2015 won't come out for months, but 2014 set another record with 1263 deaths — hundreds more than the number of Tennesseans killed in car accidents.

Overdose death counts usually come out in the middle of the following year, so Tennessee health officials won't know for months whether this key figure has begun to improve.

Reagan believes the numbers may level off this year, but he says they represent just the "tip of the iceberg." For every one overdose death, the Centers for Disease Control estimates there are 733 "non-medical users" of opiates. That means more than one in seven Tennessee residents is potentially abusing pain pills.