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Who’s Prescribing the Most Hydrocodone in Your Area?

Yesterday, the big health care news was the FDA's recommendation to impose more restrictions on how doctors prescribe hydrocodone, an opiod painkiller found in many commonly prescribed drugs, like Vicodin. As ProPublica has previously reported, these are also some of the most widely abused drugs. With this problem back in the headlines, our Prescriber Checkup news app, which covers elderly and disabled patients in Medicare's Part D program, is again a viable resource for news organizations who want to find out who's prescribing these kinds of drugs – and how much.

Using our app, you can easily search for the top prescribers of hydrocodone in your area:

  • First, select your state in the dropdown menu. You can also click on the state name in the mid-left section of the page under "Prescriptions by State." That should lead you to a page with the top specialties and top drugs for your state. Here's the one for New York, for example.
  • You can search for "hydrocodone" or sort the top drugs alphabetically and scroll down till you see "hydrocodone bit-ibuprofen" and "hydrocodone-acetaminophen." These pages will list the providers who have submitted the most Medicare claims for these drugs. Alternatively, you can search for hydrocodone in the "Top Drugs" list on the main page towards the mid-right. This will take you to a page listing the top hydrocodone prescibers in the country.
  • You can then click on the provider's name to see more information: the doctor's specialty, characteristics about the prescriber's patients, the prescriber's top-ranked drugs and how that breakdown compares with others in their specialty in state. Again, in New York, the top prescriber of hydrocodone-acetaminophen is Pravin Mehta. This doctor has filled more than 2,400 prescriptions of hydrocodone, making it his #1 drug, which is odd since it averages to the #32 drug among his peers.

Hydrocodone is one of the most commonly prescribed prescription drugs in the U.S. In 2011 alone, there were about 131 million prescriptions for products containing the popular narcotic, according to an FDA report in January.

See how doctors in your area measure up. And for more information on our Prescriber Checkup news app, read our FAQ.

Zakari Tata MD.,

Oct. 27, 2013, 6:38 a.m.

This may not be a fair representation. Some doctors practice in areas where pain is under treated. We have anecdotal stories comparing amounts of narcotics dispensed after similar fractures between urban ERs and Suburban ERs. This under treatment of pain may be a factor. Also in urban areas many people lack health insurance and so rely on the one insured family member to get scripts for all. It has also been established that people on Medicaid use more narcotics. A physician may find himself practicing is such an area where all these factors are combined. A physician practicing in an underserved area like parts of Detroit with limited doctors will have a higher rate. There have been many abuses by physicians but this report ma unfairly label some physicians who are in a high risk area. In addition based on your demographics, some specialists like orthopedic and rheumatologic doctors will refuse to prescribe you narcotics because they stereotype your demographic with abuse. This means that your local physician is stuck with prescribing narcotics that specialists have refused. Just looking at numbers is not enough.

There is one doctor in Newton, TX who has prescribed more than the population of the entire town (maybe even the entire county).  There are 4 doctors in TX that have prescribed more than the entire Parkland Hospital!!??  Does the AMA look at these numbers?

Dr. Tata, I have similar misgivings about this data, but the solution is to build on it, not dismiss it.  I’d expect a doctor to prescribe more painkillers where there’s more manual labor, for example.  If there are open databases with the information you suggest, it could be combined with what ProPublica is presenting.

Is this open information, or are these just generalizations that “everybody in the industry knows”?  If it’s the latter, I’ll stick with the numbers.  If it’s the former, though, then those numbers should be added.

Stephen Dolle

Oct. 29, 2013, 7:26 p.m.

Not only does this data not tell an accurate story of the clinical reason(s) for its use, I’d bet the most telling data that’s not included in any of these reports lies in the “economics” & income of the patients using it. Hydrocodone is by far the cheapest prescription pain drug, and where there is no or limited insurance coverage, the alternatives are a lot more expensive. And alternative (integrative & Eastern) medicine modalities like acupressure, acupuncture, message therapy, energy medicine, guided meditation, music therapy and others, all cost a lot of money, and are NOT covered by basic insurance. Shame on the FDA, DEA, Public Citizen, and the list of physicians who supported the hydrocodone reclassification. And even if and when Obamacare gets up to speed, don’t expect it to cover alternative therapies and brand name pain drugs. This whole mess is like something out of the 1930s. Haven’t we been down this road before? Oh, and get ready for all the online & street dealing of hydrocodone at 5-10 times the current price!

Actually, Vicodin is not the cheapest drug, Methadone has that distinction and is being over-used by pain doctors because of the cost and because of all the restrictions on other pain medications.  And the risks to pain patients continue…

I’d like to make 3 points.

1) the article’s description of hydrocodone, in the last paragraph, is a bit slanted toward “bad drug’ rather than “pain treatment”. Of course “Hydrocodone is one of the most commonly prescribed prescription drugs in the U.S. ” because pain is a symptom of dozens of conditions, from dental pain to post-operative pain, from arthritis to a broken leg. And while the phrase “popular narcotic”, in the same paragraph, is true in a literal sense, it also carries implications of “a bad drug [=narcotic] that people really like [popular]”.
2. While I recognize harm caused by misuse and abuse of painkillers, and the desire to lessen that harm,
    a. these campaigns always increase the stigmatization and suspicion of pain patients who deserve effective treatment just as much as patients with cancer or heart disease, and,
    b. maybe we should be asking, what is it about our Western culture which makes so many people seek refuge in drugs and alcohol. Some young people feel so empty and alienated they sniff glue, gasoline, and paint. Go up the river and find out why so many dead bodies are floating downstream.

Stephen Dolle

Nov. 18, 2013, 3:22 p.m.

I appreciate the well thought out responses in this discussion. I think we can all agree there is a drug problem in the U.S., a some level of mis-use of hydrocodone compounds. But, to enact a blanket policy that targets abusers, knowing well that responsible and truly sick patients and their physicians will be negatively impacted by the changes, lowering care and raising costs, is reckless policy. And it will serve to create a slew of new problems!

Today I received a response back on this new policy from the
Division of Drug Information, Center for Drug Evaluation and Research Food and Drug Administration. And where I had cited significant failures by FDA with respect to oversight of CNS shunts, their response indicated a position of “deniability.”

I believe the government’s increasing role and policies that interfere in the medical care and well-being of citizens is just begging for a constitutional challenge. I would support any legal challenges to these mis-directed government policy.

Stephen

joe sweeney

Feb. 10, 10:12 p.m.

i have had 4 back surgeries in the last 3 years.  docters dont like to perscribe vicodin in my 91302 area code i only take 3 a day and i dont want to buy it on the street   i have medicare insurance a&b

This new gun ho approach to stopping over prescribing of pain meds hasn’t been thought out very well as to what the addicts do if they can’t get their fix. By no means do I support the abuse of the pills but where are these people going to turn to get them. Yes the price is going to raise dramatically amd combined with the lower amount prescribed are these people going to turn to violence or maybe another drug like heroin.  It seems to me there’s is no real thought into this whole process of stopping the abuse. One side effect is what about the real people in pain. With doctors now scared to prescribe the meds due to labeling them as dealers and what not as well as some doctors looking at every patient as a drug seeking addict if they complain about pain. I have had 2 back surgeries my self my lower discs have totally blown out I have a coupe bulging discs as well combined with arthritis in my spine i have the mri and reports with me every time i see a doctor. I am 43 I work 60 hours a week my doctor has retired and every doctor I see thinks I’m there for drugs I’m willing to take drug tests and do anything to help with pain except more surgery and they still insist I’m there for drugs. It makes me furious to see doctors label me a drug addict and they dont even know me because once they hear I have pain they insist im there seeking drugs and not help I even told a couple if you can help with my pain without pills im more then willing to try yet they still think im there for drugs and theres no words to describe how much of a lowlife they make me feel like.

Chris,

You could try seeing a pain specialist. One with good credentials has the education and experience to deal with your situation instead of a knee-jerk denial of medication. In my state doctors have a legal responsibility to help a patient control his or her pain, or refer the person to another doctor who will/can do so.

Chris,

I’m from Texas, where the State Medical Board and DEA basically put the fear of God in the whole pain management industry.  Raids, intimidation, and fear are the law of the land.  It is almost impossible for pain patients in Texas to find adequate treatment.

As long as the drug war rages on, as a pain patient, you are pretty much on your own.

Do not spend your money on an expensive pain specialist.  They cannot offer you anything that will work long-term for chronic pain.  I went from taking 6 different drugs every day for pain, to not taking any at all—by switching to medical cannabis.  Sure, I had to move to New Mexico to do it, but it was worth it.

It was scary to let go of big pharma, but I can’t tell you how much easier it is to deal with intractable pain now that I am not dependent upon, and controlled by, the medical establishment.

If a 25-year intractable pain patient can survive without the medical industry, then maybe you can too?  Good luck, Chris.

Christy Summers

March 6, 1:50 a.m.

Who is Prescribing the most Hydrocodone in Memphis, Tn.

In soo much pain after durgery. Beeb without my norco.

joe sweeney

April 14, 2:15 p.m.

i get all the reasons abought pain killers. micheal jackson is a main example of the medias effect on docters overdoing it and in my experiance some ... i have had 4 major back surgeries, 4 knee surgeries, achilles tendon sewn back together, and an ankel turn a full left turn.. i am in constant pain. always.  i would rather be dead few years earlier than live in constant pain. you dont know what its like to wake up in so much pain you really cant geto ut of bed.. even with all my x-rays,mri~ c.t.scans,epidurals i still have a problem getting pain meds because docters are scared to give me pain meds.. id rather die a reasonable pain free life and take meds than live till im 80 and in constant pain..“i rather die while im livin, than live will im dead”.  JOE SWEENEY

I looking for a pain dr I’m having trouble with my spine I had a operation in 96 and it’s been a month with no improvments

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