When it comes to the opioid epidemic, physicians play a critical role in both helping to eliminate inappropriate prescribing behavior and in encouraging treatment options such as medication assisted treatment, or MAT.
While current research examines trends in the prevalence of doctor shopping, it does not often explore characteristics of providers who engage in inappropriate prescribing, either knowingly or unknowingly. When it comes to treatment, medication assisted treatment has been found to be underutilized, particularly in non-urban areas.
Hank Green, associate professor at the IU School of Public Health-Bloomington, is addressing the issue of overprescribing of opiates and under prescribing of medication assisted treatment for addiction through his Responding to the Addictions Crisis Grand Challenge project.
Green and his team will utilize a large, national medical claims dataset to create metrics that will help improve the ability to predict physician prescribing behavior and patient susceptibility to doctor shopping (obtaining controlled substances from multiple prescribers simultaneously, exceeding the recommended dosage).
The team will also study medication assisted treatment to determine physician characteristics associated with the distribution, or lack of distribution, of the treatment. Some physicians, Green said, are not familiar with the treatment and/or are unwilling to incorporate it into their practice due to the stigma associated with addiction treatment. Green and his team will look at what motivates a doctor to participate, or not participate, in MAT treatment including peer influence of other physicians; awareness of medication assisted treatment and geographic location that includes attitudes toward addiction and treatment, overdose and death rates, and local laws/policies.
Green and his team will then use that information to propose new strategies for increasing physicians’ awareness, education and willingness to recommend medication assisted treatment. Network-based interventions that utilize social learning and peer influence processes will also be created that encourage physicians to prescribe MAT and reduce the chance that they will overprescribe opiates.