Prescribing of schedule II pain medications in ambulatory medical care settings

Based on the Federal Controlled Substances Act of 1970, Schedule II (C-II) pain medications have a high potential for abuse. By identifying areas of prevalent prescribing, this research lays a foundation for future studies to examine issues such as underuse, overuse, and abuse associated with these medications.We identified variables in the 1990 National Ambulatory Medical Care Survey data set (N=43,469) theoretically associated with prescribing of controlled medications. Logistic regression analysis was employed to examine the univariate relationship of each selected variable with the likelihood of a C-II pain medication prescription and to develop a multivariable model examining the joint effects of the univariately significant factors.Geographic region, prescribing physician's specialty, patient's presenting complaint, physician's diagnosis, and diagnosis status (new versus previously diagnosed) were each associated with the likelihood of a C-II prescription. The odds of receiving a C-II pain medication increased with increasing age and with increasing duration of visit in minutes. The multivariable model included the factors, physician's specialty, duration of the visit, and physician's diagnosis.Prescribing practice does not imply drug misuse or abuse. Results of this study, however, underscore the need to consider patient-related and practice-related variables when addressing such issues.