Opioids are the mostprescribed class of prescription medications in the United States. Physicians are the legal gatekeepers for prescription medications to treat chronic pain. Over the last 10 years, prescriptions for opioid analgesics have exploded, as have emergency-room visits related to opioid overdose and death.

As physicians prescribe more opioids, there are corresponding increases in the diversion or misuse of such drugs, along with increases in adverse patient outcomes from misuse and overuse. At the same time, the costs to State Medicaid programs are accelerating with payments to physicians who prescribe, and to pharmacies who supply the medications to patients. State licensing boards and prosecutors have noticed.

They take seriously complaints from patients and pharmacies about unusual physician prescribing practices, and they have developed techniques to investigate outlier physician prescribers.

Originally published in AZMedicine - Spring 2014.