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In a novel experiment, doctors got a letter from the medical examiner's office telling them of their patient's fatal overdose. The response: They started prescribing fewer opioids. Other doctors, whose patients also overdosed, didn't get letters. Their opioid prescribing didn't change. (Johnson, 8/9)

Addressed directly to the doctor, the letter arrived in a plain business envelope with a return address of the San Diego County medical examiner’s office. Its contents were intended, ever so carefully, to focus the physician on a national epidemic of opioid abuse — and his or her possible role in it. “This is a courtesy communication to inform you that your patient [name, date of birth inserted here] died on [date inserted here]. Prescription drug overdose was either the primary cause of death or contributed to the death,” the letter read. (Healy, 8/9)

Kaiser Health News: Clinicians Who Learn Of A Patient’s Opioid Death Modestly Cut Back On Prescriptions 

“You can hear a lot of statistics about the crisis,” said Jason Doctor, lead author of the study, published Thursday in the journal Science. “But it always feels like it is happening elsewhere if you are not aware of any deaths in your own practice.” (Gorman, 8/10)

The letters were successful, although the effects were modest. Doctors who were informed of their patients' deaths were 7 percent less likely to start new patients on opioids and issued fewer high-dose prescriptions over the next three months, compared with those who did not receive a letter. In total, there was a 9.7 percent reduction in the total amount of opioids they prescribed, according to results published Thursday in the journal Science. (Johnson, 8/9)

"What's important about what we've found is that you can do very simple things to change prescribing and make prescribing safer," says coauthor Jason Doctor, an associate professor of health policy and management at the University of Southern California. (Watson, 8/9)

“I think it’s a no-brainer,” said Dr. Andrew Kolodny, co-director of Brandeis University’s Opioid Policy Research Collaborative, who was not involved with the study. “If a prescriber’s patient ultimately loses their life to a drug overdose, that prescriber should be notified — there should be that feedback.” Still, such an effort wouldn’t be feasible everywhere, said Dr. Kim Collins, a forensic pathologist in South Carolina and 2018 president of the National Association of Medical Examiners. Depending on a jurisdiction’s policies and coroner and medical examiner system, pathologists can’t always disclose causes of death of individual patients. (Joseph, 8/9)