LA County Considers Alerting Prescribers to Opioid Deaths as Prevention Tool

The Los Angeles County Board of Supervisors voted Tuesday to consider notifying prescribing physicians when a patient dies of an opioid overdose, as a way to make doctors think twice about prescribing the drugs.

Supervisors Janice Hahn and Hilda Solis recommended the alerts, citing research published by Dr. Jonathan Lucas, the county's chief medical examiner-coroner.

"Opioid addiction is unique -- it doesn't start at a party or on the streets -- it starts in a doctor's office,'' Hahn said. "Our doctors need to know in a real, tangible way the consequences of these drugs and this is an opportunity for the county to work in a creative way to help them become part of the solution.''

Lucas began sending letters to doctors while working as the chief deputy medical examiner in San Diego County.

Research by Lucas and others found that doctors wrote nearly 10 percent fewer opioid prescriptions over a three-month period following receipt of a letter notifying them that a patient had died and offering an admonition about safe prescribing. The study involved 861 clinicians prescribing to 170 patients who subsequently suffered fatal overdoses.

"Awareness works,'' Lucas said.  "Alerting doctors about patient overdose deaths is a unique opportunity for the department to have an impact on public health, effect change and potentially save lives.''

In 2017, 488 Los Angeles County residents died from opioid-related overdoses, according to the motion introduced Hahn and Solis.

Solis said outreach was key to prevention.

"To effectively tackle the opioid crisis, we must think outside of the box, advocate, and expand our reach to help as many people as possible, and that includes helping our most vulnerable residents and immigrant communities,'' she said. "No one should be left behind in this effort.''

In a separate motion, also co-authored by Solis and Hahn, the board called on public health officials to expand opioid addiction treatment programs and secure more funding for the use of naloxone -- a drug designed to rapidly reverse an opioid overdose -- by first-responders and law enforcement personnel.

The research study on alerting doctors to overdoses, published last week in the journal Science, is available at

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