1085 Geographical and Temporal Trends in Opioid Prescriptions by U.S. Neurosurgeons, 2013-2021: A Medicare Part D Analysis

INTRODUCTION: In the aftermath of the pandemic, opioid-related overdose fatalities have surged to unprecedented levels.1 Amidst the ongoing battle against opioid mortality, it is imperative to recognize the indispensable role these medications play in patient care. Frequently administered following invasive procedures, opioids represent a complex facet of pain management. Vigilant monitoring of prescription practices among neurosurgeons remains crucial to safeguarding their appropriate administration. METHODS: The Medicare Part D database was queried and the seven most frequently prescribed opioids by neurosurgeons were identified. Data on beneficiaries, prescription amount and refills were tabulated from 2013 to 2021. RESULTS: Between 2013 and 2021, opioid prescriptions by neurosurgeons to Medicare beneficiaries in the US dropped by 51.99%, from 379,346 to 182,097. This decline was consistent across all regions . The mean length of prescriptions decreased slightly from 22.75 days in 2013 to 21.25 days in 2021 (-6.59%). Hydrocodone, the most prescribed opioid in 2013, saw a significant reduction in the percentage of total prescriptions, dropping from 63.42% in 2013 to 43.66% in 2021. The total number of opioid beneficiaries declined by 39.61%, from 143,347 in 2013 to 86,565 in 2021, with a similar trend observed in the elderly demographic (44.48% decrease from 45,856 to 25,460). CONCLUSIONS: This study provides a comprehensive analysis of opioid prescription trends among U.S. neurosurgeons over nine years, revealing a substantial decline in prescriptions. Geographical patterns remained consistent, with regulatory changes and COVID-19 policies likely influencing prescription trends.