Opioid-Prescribing Trends in Dermatology From 2014 to 2020 in the United States

Introduction The opioid epidemic is a critical public health crisis, with opioid overdose deaths being a leading cause of injury-related deaths in the United States. Dermatology, though a small contributor to overall opioid prescriptions, still accounts for over 700,000 opioid pills annually. Reducing opioid prescribing in this specialty has been challenging due to limited comprehensive research. This study aimed to investigate opioid-prescribing trends in dermatology across all nine US regions over seven years. Methods Data on opioid prescriptions by dermatologists from 2014 to 2020 were collected retrospectively from the Medicare Part D Prescribers by Provider database, available through the United States Centers for Medicare and Medicaid Services (CMS). The data were analyzed nationally and by geographic division, using US census population estimates for the respective states to calculate rates per population. Over the years studied, opioid prescription claims, the number of dermatologists, and the proportion of dermatologists prescribing opioids gradually decreased both by average and by population. Results Over the years evaluated, there were a total of 618,714 claims for short-acting opioids throughout the United States. Prescription claims, the number of dermatologists, and the proportion of dermatologists prescribing opioids all saw a gradual decrease in numbers by average and by population. Claims per year decreased from 2,023 in 2014 to 1,124 in 2020. Dermatologists per 10,000 people decreased from 0.35 in 2014 and 2015 to 0.32 in 2020. The percentage of dermatologists prescribing opioids decreased from 16.5% (0.06 per 10,000 people) in 2014 to 9.14% (0.03 per 10,000 people) in 2020. Over the seven-year period, the geographic state divisions that make up the south region had the most claims by population with 3330 claims in division 5 (3.9 per 10,000 people), 2531 claims in division 6 (5.2 per 10,000 people), and 3287 claims in division 7 (2.97 claims per 10,000 people). Division 1 had the least amount, with 0.6 claims per 10,000 people. Conclusion The findings show a gradual decline in opioid prescriptions by dermatologists, consistent with the national trend. Moreover, there are significant regional variations in opioid prescribing, with the southern states having the highest prescribing rates. The study highlights the need for targeted education policies to address regional variations and promote standardized opioid protocols in dermatology practice.