Precipitous decline in opioid prescribing in large network of Community Health Centers

Nurse at Community Health Clinic

In a JAMA article published last week, researchers from OHSU Family Medicine and OCHIN found that opioid prescribing decreased across a large network of Community Health Centers (CHCs) between 2009 and 2018 — a decrease that happened earlier and more precipitously than in national population estimates.

In 2009, the national opioid problem was being recognized as an epidemic, with an estimated 79.5 opioid prescriptions written for every 100 Americans. In OCHIN’s system of safety-net clinics, that rate was even higher — 110.8 prescriptions per 100 patients.

Opioid prescribing data

Between 2009 and 2018, the annual number of prescriptions decreased 73.7% among OCHIN-tracked patients, compared to a 36.7% decrease nationally. This precipitous decline likely reflects federal, state, and local efforts to mitigate harms from increased opioid prescribing, as well as strong clinical quality improvement strategies within CHCs. Despite serving populations that generally have greater physical and mental health comorbidity and are more impoverished, studies have shown that CHCs often surpass private clinics in quality metrics.

The authors hope that understanding opioid prescribing patterns in CHCs may help to guide strategies to reduce opioid-related harms for high-risk patients. Further studies are needed to determine what specific policies and measures were most effective in these efforts.

OHSU Family Medicine authors are John Muench, M.D., M.P.H.; Katie Fankhauser, M.P.H.; Nathalie Huguet, Ph.D.; Jean O’Malley, M.P.H.; Steffani R. Bailey, Ph.D.; Maria Ukhanova, M.D., Ph.D.; and Irina Chamine, Ph.D. This work was funded by NIDA grant R01A046468.

Read the full paper on the JAMA website here.

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