Opioid Overprescribing
The term for when opioids are prescribed in excess of what patients actually need is "overprescribing" or "inappropriate prescribing" 1, 2, 1. This phenomenon is also described in the literature as "excessive opioid prescribing" 2.
Understanding the Terminology
Overprescribing specifically refers to prescribing opioids in quantities that exceed what patients require for adequate pain management, resulting in leftover pills that contribute to diversion, misuse, and the broader opioid epidemic 1, 2, 1. The medical literature consistently documents that opioids are "frequently overprescribed after surgery" and "prescribed in excess of the quantity needed by patients to manage postoperative pain" 1.
Related Terms You Should Know
While "overprescribing" is the primary term, the literature uses several related concepts:
- "Inappropriate prescribing" - a broader term encompassing overprescribing as well as other problematic prescribing patterns 1
- "Excessive opioid prescribing" - emphasizing the quantity aspect 2
- "Misprescribing" - an umbrella term that includes multiple categories: inadvertent overprescribing, corrupt overprescribing, qualitative overprescribing, quantitative overprescribing, multiclass overprescribing, and underprescribing 3
Clinical Context and Consequences
The consequences of overprescribing are severe and well-documented 2:
- Diversion of leftover pills into the community - unused opioids become a major source of nonmedical opioid use
- Rising rates of opioid use disorder - 6-7% of previously opioid-naïve patients develop persistent opioid use beyond 3 months after surgery 1
- Increased overdose deaths - prescription opioids accounted for 40% of more than 42,000 opioid-related overdose deaths in 2016 1
- Gateway to illicit drug use - unused prescription opioids are the most common initial opioid exposure for individuals who develop opioid use disorder related to heroin 2
The Scale of the Problem
Recent evidence demonstrates the magnitude of overprescribing 2:
- Studies involving 13,591 patients showed that implementing evidence-based prescribing recommendations resulted in 37-63% reductions in opioid prescribing without increasing refill requests or patient-reported pain scores
- This dramatic reduction was achieved without adversely affecting patient outcomes, confirming that the original prescribing patterns represented substantial overprescribing