‘Death Diaries’ project reveals disturbing patterns in opioid prescribing

Opioid abuse Shutterstock 315x210 Death Diaries project reveals disturbing patterns in opioid prescribingA doctor in San Diego, California, is working to fight the opioid epidemic by leading an effort to prevent future prescription drug overdose fatalities through the “San Diego Death Diaries,” a project that examines what drugs killed 254 people in 2013, and who prescribed them.

Dr. Roneet Lev, head of emergency medicine at Scripps Mercy Hospital, set out to discover why there were so many unintended overdose deaths. She gathered information for 254 people who died of a drug overdose in 2013, and for each she created a diary entry that consists of the decedent’s name, age, and a list of medications they overdosed on. It also included a yearlong history of the person’s medications, the doctors who prescribed them and the pharmacies that filled them. There were no other details about the patients. Just those facts.

From the diary, Dr. Lev discovered some concerning patterns in the decedents, such as doctor-shopping patients, people who mix medications with other substances, and doctors who didn’t seem to be paying attention to the prescribing histories of their patients.

Her research also revealed that oxycodone had the most prescriptions written for it and was also connected to the most deaths. About 80 percent of the people who died had mixed prescription medication with alcohol, over-the-counter medicines, or illicit drugs. One of the deadliest combinations was mixing opioids with benzodiazepines, like Xanax, Ativan, Valium or Klonopin.

Doctors are encouraged to check their patients’ drug history in a national database before prescribing new medication. But Dr. Lev said there are indications that many doctors don’t use the database regularly.

Dr. Lev said she hopes the “Death Diaries” make doctors, like her, more aware of the growing prescription drug problem. The first step in doing that was to send letters to hundreds of doctors across the country informing them that they had prescribed lethal drugs to someone who had recently died while taking that medication. She’s hoping the letter will change their prescribing practices.

Source: The San Diego Union-Tribune