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Her team sought to identify which physicians in which settings are prescribing these drugs and found the most frequent first prescribers of opioids are emergency room physicians while general neurologists were most frequent first prescribers of barbiturates. Primary care physicians were also identified as first prescribers.
Such medications have been designated as inappropriate as first line treatment for migraine patients by the American Board of Internal Medicine's "Choosing Wisely" campaign. The campaign recommends that first medications for migraine be either non-prescription pain medications or a class of prescription drugs called triptans that are specifically for migraine.
"Taken as a whole, these data provide a useful snapshot of the wide variety of physician specialties that might benefit from additional education on the appropriate use of opioids and barbiturate-containing medications in patients with headaches," Dr. Minen said.