Dermatologists are increasing their use of non-opioid pain medications faster than opioids

Abstract

Introduction

There is a lack of consensus in the literature on how and when dermatologists should prescribe pain medications. As there is an ongoing opioid abuse epidemic driven by prescription opioids, it is important for all fields to investigate their own prescribing patterns.

Methods

We analyzed the National Ambulatory Medical Care Survey from 2007 to 2016 to assess the usage of systemic pain medications amongst dermatologists.

Results

There were 16,777 total visits with dermatologists which represents 368 (95% confidence interval 363, 373) million estimated visits. Opioids were used at 1.4% (1.3, 1.6) of visits. As relative proportions, opioids were 35.6 (31.7, 39.6) of all systemic pain medication and non-opioids were 64.4% (53.8, 74.9). The use of opioid (p=.01 [odds ratio 1.08 (1.02, 1.14)]) and non-opioid (p<.001 [odds ratio 1.12 (1.07, 1.17)]) medications increased over the study interval.

Conclusion

Pain medications were used at a relatively small proportion of visits with dermatologists. Opioids were nearly half of all pain medications used. The use of opioids and non-opioids rose over the study interval, however, non-opioids rose at a faster rate. The faster rise of non-opioids may indicate that dermatologists are making an effort to use medications with less potential for abuse.

Keywords:

• Narcotic
• analgesic
• skin
• public health

Disclosure statement

Dr. Fleischer is a consultant for Boerhringer-Ingelheim, Dermavant, Incyte, Qurient, SCM Lifescience and Syneos. He is an investigator for Galderma, Menlo and Trevi. He has no other potential conflicts including Honoraria, Speakers bureau, Stock ownership or options, Expert testimony, Grants, Patents filed, received, pending, or in preparation, Royalties, or Donation of medical equipment. Suraj Muddasani and Gabrielle Peck have no conflicts of interest.