PRESCRIBING OF SCHEDULE-II PAIN MEDICATIONS IN AMBULATORY MEDICAL-CARE SETTINGS

Based an the Federal Controlled Substances Act of 1970, Schedule II (C -II) pain medications have a high potential for abuse. By identifying areas of prevalent prescribing, this research lays a foundation for fu ture studies to examine issues such as underuse, overuse, and abuse as sociated with these medications.We identified variables in the 1990 Na tional Ambulatory Medical Care Survey data set (N = 43,469) theoretica lly associated with prescribing of controlled medications. Logistic re gression analysis was employed to examine the univariate relationship of each selected variable with the likelihood of a C-II pain medicatio n prescription and to develop a multivariable model examining the join t effects of the univariately significant factors. Geographic region, prescribing physician's specialty patient's presenting complaint, phys ician's diagnosis, and diagnosis status (new versus previously diagnos ed) were each associated with the likelihood of a C-II prescription. T he odds of receiving a C-II pain medication increased with increasing age and with increasing duration of visit in minutes. The multivariabl e model included the factors, physician's specialty, duration of the v isit, and physician's diagnosis. Prescribing practice does not imply d rug misuse or abuse. Results of this study, however, underscore the ne ed to consider patient-related and practice-related variables when add ressing such issues.