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Physicians from lower-ranked medical schools prescribe nearly three times as many opioids per year as graduates from top-tier institutions, says a new study by two Princeton University economics professors. Clinical use of prescription opioids has quadrupled since 1999, almost exactly…

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study was published as a working paper for discussion by the National Bureau of Economic Research (NBER), the largest economics research organization in the country.

Striking relationship

“Using data on all opioid prescriptions written by physicians from 2006 to 2014, we uncover a striking relationship between opioid prescribing and medical school rank,” wrote the paper’s authors, Janet Currie, PhD, and Molly Schnell, a PhD candidate. “Even within the same specialty and county of practice, physicians who completed their initial training at top medical schools write significantly fewer opioid prescriptions annually than physicians from lower ranked schools.”

It’s unlikely that these differences in prescribing decisions were due to some sort of differences in the patients seen by doctors from higher- and lower-ranked schools. The study points out that the evidence was the same across geographic regions, across specialties, and even within the same hospitals.

“The relationship between medical school rank and propensity to prescribe opioids persists even among specialists who attended different medical schools but practice in the exact same hospital or clinic-where patients can be assumed to be relatively homogenous in their need for opioids,” the study said.

This additional evidence, they said, suggests “a causal effect of education rather than patient selection across physicians or physician selection across medical schools. Altering physician education may therefore be a useful policy tool in fighting the current epidemic.”

Overall, physicians from Harvard wrote fewer than 100 opioid prescriptions a year, compared to physicians from the lowest-ranked schools who wrote 300 a year. But the most striking differences were found among general practitioners, who accounted for nearly half of all opioids prescribed during the study period.

Harvard grad GPs wrote an average of 180 opioid prescriptions a year, while GPs from the lowest-ranked schools averaged 550 prescriptions a year.

Meanwhile at Harvard…

A year ago, the Obama White House asked medical schools “to sign a pledge” to require students to study new guidelines from the CDC for safe opioid prescribing before they graduate. According to a MedPage Today report, “of the nation’s 170-plus medical schools, 61 signed on.”

Harvard Med was one of those that refused to make the “pledge” to implement the CDC guidelines, saying that safe opioid prescribing is already part of the curriculum. But a group of Harvard med students said they weren’t satisfied with their education on opioids. So a group of them organized additional training on better opioid prescribing practices and how to more effectively treat addiction using the opioid overdose reversal drug naloxone (trade name Narcan).

MedPage said their efforts took place “amid a surge in deaths from opioid overdoses, which killed an estimated 28,000 people in the United States in 2014. And at least half of those deaths involved a drug prescribed by a doctor.”

Take it to the next step

The 61 schools that accepted the White House’s pledge to implement the CDC guidelines have begun enhancing their opioid training.

The NBER study’s Molly Schnell told MedPage that if the CDC training turns out to be effective, and if her medical education research gets “sufficient attention,” she and others could start to examine medical education and training “on a more granular level.”

“One thing we would love is to start working with medical schools to maybe know what they’ve been teaching and see if we can pinpoint which strategies are most effective,” Schnell said.

Meanwhile, here at Novus we help patients get their lives back from opioid dependence every day. Our development of innovative opioid detox protocols shows we’re on board with improving treatment methodologies. We congratulate those enterprising, proactive Harvard students, and all the med schools, seeking to find better ways to make a difference.

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President Trump's newly appointed FDA Commissioner, Scott Gottlieb, told his first gathering of agency staff last week that "unquestionably, our greatest immediate challenge is the problem of opioid abuse." Gottlieb said the opioid epidemic is "a public health crisis of staggering human and…

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Novus is the best way to get your life back as painlessly as possible.

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A new study by Columbia University Medical Center in New York City has found that every state that has legalized medical marijuana is experiencing increases in recreational use and use disorders. At the same time, the study says, states that have not legalized medical marijuana have declining…

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A recent study of the prescribing practices of emergency room physicians clearly shows that the more opioids you prescribe, the more long-term use and abuse will result - especially among the elderly. The study, published in New England Journal of Medicine, analyzed opioid prescriptions among…

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Are America's physicians responsible for the soaring rate of opioid abuse and overdose deaths across the country? "Not exclusively," says Dr. F. Perry Wilson. "But we can't deny that somewhere in the chain of events that leads to opioid abuse lies a prescription pad." Wilson, a MedPage Today…

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Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

Neonatal abstinence syndrome among infants in rural areas increased 600 percent from 2004 to 2013 – more than double the increase in urban areas – according to a study by the University of Michigan. Neonatal abstinence syndrome, or NAS, is the medical term for newborns suffering withdrawal…

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Thirty-five states and the District of Columbia have filed an antitrust lawsuit alleging that two pharmaceutical Suboxone Drugmaker companies have conspired to keep a cheaper generic version of Suboxone off the market. The lawsuit claims that British drugmaker Indivior, along with a New Jersey…

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This November, California voters will go to the polls to decide if their state will join Colorado, Washington, Alaska and Oregon in allowing the recreational use of marijuana as part of the Recreational Marijuana Initiative. Back in 1996, Californians voted "Yes" to Proposition 215 making it the…

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Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

Close to a dozen abuse-deterrent prescription opioid painkillers have been approved by the FDA Panel over the past few years. Already this year, three more companies have submitted new opioid painkillers with abuse-deterrent formulation for approval. (Abuse deterrence means that the pills,…

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Just weeks after the Senate passed the historic Comprehensive Addiction and Recovery Act (CARA) by an overwhelming bipartisan vote of 94-to-1, Congress has again demonstrated broad bipartisan support for the battle against America's opioid epidemic. And then just a few weeks ago, House lawmakers…

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