A report by the insurance industry group AHIP (America’s Health Insurance Plans) suggests that physicians still have a way to go to be in compliance with the 2016 opioid prescribing and monitoring recommendations from the Centers for Disease Control and Prevention. And when it comes to instituting urine drug testing, they have a very long way to go indeed.

Drawing on prescribing data from member insurance providers, they found:

• 99.7% compliance with the recommendation that opioid prescribing begin with immediate-release, not extended-release, formulations.
• 75% compliance with the recommendation that initial prescriptions be less than 50 morphine milligram equivalents daily.
• 57% compliance with the recommendation that initial prescriptions for acute pain be for 3 days or less, although the recommendation does recognize that more will sometimes be needed.
• 52%-57% compliance with the recommendation for a follow-up evaluation visit within 30 days of the initial prescription.
• 1% compliance with the recommendation that patients receive a baseline urine drug test before beginning opioid therapy.
• 6%-15% compliance with the recommendation that urine drug testing be repeated at least annually.
• Less than 60% compliance with the recommendation that patients not receive benzodiazepines and opioids at the same time.

The group also published a detailed methodology so that other health insurance plans can implement similar monitoring within their own networks.