OPIOID OVERDOSE AND THE ROLE OF PRESCRIBER EDUCATION | 1

Opioid Overdose and the Role of Prescriber Education

While prescription opioid misuse has declined in recent years, it continues 

to be an important driver of the opioid epidemic. Prescription opioids were 

misused by more than 8.8 million Americans1and involved in more than 

16,000 fatal overdoses in 2021.

2

Prescribers can continue to play a key role in reducing prescription opioid misuse.

3 Changes in 

prescribing habits can decrease unnecessary use and educating their patients about the proper 

use, handling, and safeguarding of opioids.

WHAT IS PRESCRIBER EDUCATION?

One strategy for preventing overprescribing and ensuring the safe use of prescription opioid pain 

relievers is to provide education to prescribers. In this context, prescriber education seeks to 

accomplish one or more of the following, interrelated goals:

 Raise prescriber and patient understanding of the benefits and risks of opioids

 Increase prescriber utilization of strategies to address unsafe opioid use

 Expand patient use of alternative pain relief options when appropriate

 Improve patient access to opioid overdose antidotes and treatment for 

substance use disorders

 Ensure patients have safe, appropriate access to opioids, when needed

Identifying Needs and 

Opportunities for Collaboration
OPIOID OVERDOSE AND THE ROLE OF PRESCRIBER EDUCATION | 2

WHY ENGAGE IN PRESCRIBER EDUCATION?

Prescribers are gatekeepers for, and primary/credible sources of guidance on, prescription 

opioids. They are uniquely positioned to help maintain legitimate and appropriate access to 

opioids for patients, promote their safe use, and identify patients at risk for opioid overdose 

through their own prescribing practices and ongoing patient communications and interactions. 

Prescriber education can reduce opioid overdose by helping to:

Decrease the inappropriate supply of prescription opioids.

Prescribers can reduce the amount of opioids available for non-medical purposes

through education interventions that help them think critically about their prescribing 

practices or present clear guidelines for prescribing. Reducing overprescribing can 

decrease rates of opioid misuse and overdose, while ensuring that patients receive 

appropriate treatment. Effective prescriber education can help providers strike a 

balance between preventing inappropriate access and ensuring legitimate availability.

Unused or expired prescriptions may also become an inappropriate source of opioids

among a patient’s family members or friends. Prescriber education focused on how to 

discuss appropriate disposal strategies with patients could help reduce excess supply 

and lessen the chance of misuse.

4

Balance Is Key. The number of doctors prescribing opioids has fallen in recent 

years after more than a decade of rising office-based physician visits for pain.5,6

Part of this decline may be attributed to the CDC’s 2016 “Guidelines for 

Prescribing Opioids for Chronic Pain,” which introduced stricter standards for 

prescribers. The CDC’s guidelines were associated with less opioid prescribing and

reductions in high-risk prescribing. However, many people with legitimate medical 

needs experienced reduced access to prescription opioids, potentially resulting in 

psychological distress and physical pain.2

Lessen inappropriate demand for prescription opioids.

Due to more than two decades of liberally prescribing opioids to address pain 

management, some patients meet prescribers with the expectation of receiving an 

opioid prescription to treat pain. Others may go with the intention of obtaining opioids 

for deliberate misuse (i.e., doctor shopping). For these patients, prescribers can be a key 

source of information on both the risks and safe use of prescription opioids. Prescribers

are also uniquely positioned to engage in conversations about prescription opioids, 

identify patients with or who are at risk for opioid use disorders, and refer them to 
OPIOID OVERDOSE AND THE ROLE OF PRESCRIBER EDUCATION | 3

treatment. 7,8 Prescriber education approaches, such as academic detailing, can help to 

prepare prescribers for these important conversations.9

Academic Detailing is an evidence-based prescriber education approach that 

involves structured, one-on-one visits between trained educators and prescribers.

Through these interactive visits, the educator assesses a prescriber’s unique 

needs, attitudes, and knowledge about prescribing practices. They then deliver

key messages that link prescription research to recommendations for behavior 

change that aligns with best prescriber practices. The educator also seeks to

address any barriers or objections to implementation raised by the prescriber.

Academic detailing has been shown to improve clinican knowledge of and 

adherence to appropriate opioid prescribing.

10

Increase use of alternative approaches to address pain.

Prescriber education can also provide information on appropriate alternatives to 

opioids. While opioid prescribing rates decreased from 2011 through 2018, non-opioid 

pain medication prescribing rates increased over the same period, indicating that 

alternative approaches to address pain are being embraced by the medical 

community.

11 But evidence suggests that prescribers are eager for more education on 

alternative methods to address pain management.7,8,12,13 Given the wide scope of 

providers who can fill prescriptions for pain (e.g., dentists, rehabilitation clinicians, 

oncologists, etc.), prescriber education efforts targeting non-opioid alternatives should 

be accessible across multiple different medical specializations.2

Reduce the risk of overdose by expanding access to naloxone.

Even when opioids are prescribed appropriately, it is important for prescribers to 

address the potential for overdose. Prescriber education on the importance of harm 

reduction interventions, such as providing an opioid antitode (e.g., naloxone), can help 

expand overdose prevention efforts. For example, as of September 2023, 20 states had 

enacted co-prescription regulations, which suggest co-prescribing naloxone in 

conjunction with a prescription opioid. In 12 of these states, co-prescribing is mandatory 

in certain situations.

14
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IMPLEMENTING PRESCRIBER EDUCATION

Existing research indicates that prescriber education is an effective strategy to reduce opioid 

misuse, and has been found effective at reducing opioid prescribing rates upon hospital 

discharge by as much as 59%.15 Additionally, brief educational interventions (e.g., half-day 

workshops or a series of hour-long lectures) have been shown to be effective in improving 

clinical knowledge and confidence in prescribing opioids among both medical students16 and 

seasoned physicians.17

Prescriber Education at Work. Implementation of a multimodal prescriber education 

program in Washington and Oregon was associated with a nine-fold increase in the 

number of primary care providers trained and willing to provide buprenorphine. The 

program included an educational video, toolkit, monthly newsletter and conference call, 

and 1-on-1 coaching.18

To begin implementing this evidence-based practice, it is important for prevention professionals 

to understand the lay of the land in which they operate. Rules and regulations about opioid 

prescribing can vary considerably across jurisdictions. Understanding who can prescribe opioids, 

their current educational requirements, and the existing resources available for further 

education is critical to building a successful prescriber education program.

REFERENCES

1. SAMHSA. (2023). Results from the 2022 National Survey on Drug Use and Health: Detailed tables. U.S. 

Department of Health and Human Services.

2. National Institute on Drug Abuse. (2023). Overdose death rates. National Institutes of Health, U.S. 

Department of Health and Human Services. https://nida.nih.gov/research-topics/trendsstatistics/overdose-death-rates

3. Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC clinical practice guidelines 

for prescribing opioids for pain: United States, 2022. MMWR, 71(RR-3), 1-95. 

https://doi.org/10.15585/mmwr.rr7103a1

4. Ghandi, T., & Best, K. (2015). Educate patients about proper disposal of unused Rx medications: For their 

safety. Current Psychiatry, 14(4), 60-67. https://cdn.mdedge.com/files/s3fspublic/issues/articles/060_0415CP_PRLS_Ghandi_FINAL.pdf

5. Gray, B. M, Vandergrift, J. L., Weng, W., Lipner, R. S., & Barnett, M. L. (2021). Clinical knowledge and 

trends in physicians’ prescribing of opioids for new onset back pain, 2009-2017. JAMA Network Open, 

4(7), e2115328. https://doi.org/10.1001/jamanetworkopen.2021.15328
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191(19), E546-E547. https://doi.org/10.1503/cmaj.109-5748

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academic detailing. Pain Physician, 20(2S), S147–S151. https://pubmed.ncbi.nlm.nih.gov/28226336/

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Chronic Pain. JAMA Network Open, 5(6), e2216475. 

https://doi.org/10.1001/jamanetworkopen.2022.16475

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Management, 15(6), 479-485. https://doi.org/10.5055/jom.2019.0538

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https://doi.org/10.3399/bjgp20X711737

14. Legislative Analysis and Public Policy Association. (2023). Naloxone access: Summary of state laws.

https://legislativeanalysis.org/wp-content/uploads/2023/02/Naloxone-Access-Summary-of-StateLaws.pdf

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medical assistance in dying. Nurse Practitioner Open Journal, 3(1), 22-32. 

https://npopenjournal.com/index.php/npoj/article/view/402/415

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Interprofessional learner perceptions of a brief educational intervention about opioid prescribing for 
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older adults. Journal of the American Geriatrics Society, 71(6), E19-E22. 

https://doi.org/10.1111/jgs.18358

18. Clark, B., Kai, M., Dix, R., White, J., Rozenfeld, Y., Levy, S., & Engstrom, K. (2019). Association of a 

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opioid use disorders. JAMA Network Open, 2(10), e1913818. 

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SPTAC@edc.org | samhsa.gov/SPTAC