Opioid Prescribing by Emergency Physicians and Risk of Long-Term Use

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Abstract
To the Editor: Barnett et al. (Feb. 16 issue)1 affirm a key hypothesis: seemingly random clinical exposure to opioids facilitates long-term use, at least among Medicare patients. Without careful inspection, readers may incorrectly interpret this finding to suggest that emergency physicians are key drivers of the opioid epidemic. Nationally, emergency department encounters account for only 5% of all opioids prescribed, even though they constitute more than 10% of all ambulatory visits.2This study shows that the risk of long-term opioid use after treatment in an emergency department by a “high-intensity prescriber” is small at 1.51%, as compared with a 1.16% . . .