An alternative method for the identification of potential habitual narcotic users from a managed care claims database

The purpose of this study was to identify an alternative method of initial narcotic abuse screening to distinguish members who have a greater likelihood of being correctly classified as potential narcotic abusers. Members 10 years of age and older, who had one or more pharmacy claims for narcotics within a quarter were included in the analysis. Members were classified according to the number of narcotic prescriptions, unique pharmacies, and unique physicians in a quarter. Those with excluded medical conditions and abuse-related diagnoses were identified. A narcotic abuse decision tree was developed to identify population(s) with the highest likelihood for a potential abuse history. Using a combination of variables, especially age, strengthened the likelihood of identifying potential narcotic abusers.