Why addiction risk algorithms could be making the opioid crisis worse

The algorithms used by states' prescription monitoring systems sometimes block chronic pain sufferers from receiving opioids after inaccurately flagging them as potential addicts, Wired reported Aug. 11.

In June, Missouri became the 50th state to establish a statewide prescription drug monitoring program. These systems use algorithms to generate insights about patients' prescription drug habits. Through these algorithms, state prescription drug monitoring programs identify patients' risk of misusing opioids and often assign them a "overdose risk score." 

Several patients who are not addicted to opioids told Wired their state's prescription monitoring system inaccurately flagged them as misusing the drugs, therefore cutting off their access to the drugs that relieves their chronic pain. They told the outlet their situation prompted them to search for answers online, where they found a community of chronic pain patients who experienced the same mischaracterization.

The reasons these algorithms inaccurately flag patients can vary. For example, sometimes the system flags patients for having multiple opioids prescriptions for their pets, and sometimes it flags patients with anxiety and post-traumatic stress disorder for having concurrent benzodiazepine prescriptions.

Research shows 20 percent of patients who are most likely to be flagged for seeking multiple opioid prescriptions from different physicians are cancer patients, so they are required to see multiple specialists, according to Wired.

"[M]any of the official red flags that increase a person's risk scores are simply attributes of the most vulnerable and medically complex patients, sometimes causing those groups to be denied opioid pain treatment," the report said.

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