HHS: SAME OLD PIG – just new color of lipstick

HHS OIG Toolkits for Calculating Opioid Levels and Identifying Patients At Risk of Misuse or Overdose



OIG has developed two toolkits that provide detailed steps for using prescription drug claims data to analyze patients’ opioid levels to identify certain patients at risk of opioid misuse or overdose. The first toolkit includes SAS programming code. The second toolkit includes R and SQL programming code. Both toolkits are based on the methodology that OIG developed for its extensive work on opioid use in Medicare Part D.

The toolkits provide highly technical information to assist our public and private sector partners—such as Medicare Part D plan sponsors, private health plans, and State Medicaid Fraud Control Units—with analyzing their own prescription drug claims data to help combat the opioid crisis.


The opioid crisis remains a public health emergency. As one of the lead Federal agencies fighting health care fraud, OIG is committed to supporting our public and private partners in their efforts to curb the opioid epidemic. These toolkits and the accompanying code can be used to analyze claims data for prescription drugs and identify patients who may be misusing or abusing prescription opioids and may be in need of additional case management or other followup. These toolkits and accompanying code can also be used to answer research questions about opioid utilization. These types of efforts are particularly important given the COVID-19 pandemic. The National Institutes of Health recently issued a warning that individuals with opioid use disorder could be particularly hard hit by COVID-19, as it is a disease that attacks the lungs. Respiratory disease is known to increase mortality risk among people taking opioids.

OIG has developed extensive work on opioid use in Medicare Part D. OIG most recently analyzed opioid levels in Medicare Part D in a data brief entitled (OEI-02-19-00390). The data brief identified almost 49,000 Part D beneficiaries who were at serious risk of misuse or overdose. Some of these beneficiaries received extreme amounts of opioids. Others appeared to be “doctor shopping”-i.e., receiving high amounts of opioids from multiple prescribers and multiple pharmacies. The analysis identified beneficiaries who are at risk by calculating their opioid levels using Part D prescription drug data.


These toolkits provide steps to calculate patients’ average daily morphine equivalent dose (MED), which converts various prescription opioids and strengths into one standard value. This measure is also called morphine milligram equivalent (MME). The toolkits include a detailed description of the analysis and programming code in three different programming languages (SAS, R, and SQL) that can be applied to the user’s own data. The SAS code, R code, and SQL code provide the same data. These data can be used to identify certain patients who are at risk of opioid misuse or overdose. Users can also modify the code to meet their needs, such as identifying patients at varying levels of risk.

There are two toolkits. For the SAS code, use this . For the R or SQL code, use this . The toolkits start with the same two chapters: (1) Analysis of Prescription Drug Claims Data; and (2) Explanation of the Programming Code To Conduct the Analysis. The remaining chapters contain the programming code.

5 Responses

  1. Dear Steven, this sort of reminds me of what Nazi Germany must have been like. Disturbing! Please email me. Need advice: cfc@breezeline.net CFC,DO

  2. The tortures are the hero’s,,,whilst the humane doctors are arrrested and jail.Torture has become addictionist new commodity,,thus the dance on all our graves. Giving us laws on how we all are to die in forced agony. Proving Evil is truly sufferable, For no-where on Gods earth,is torture upon the sick,the dieing,children included ever the rite thing to do, not even under the color of law,,,,,,,,

  3. They are never going to stop until every last pain patient is dead. Deny until dead.

    • I don’t disagree,but do u think is a population control thing,,,or a $$$$$$ thing,,orrrrr its because all of us who once had an ,”effective dose,” for years,,that worked,,,we found out,,opiates work well long term,I mean THEY WORKD..All our bodies internally were happy,,,my bp went back to perfect 110/70 w/my opiate medicine,now all over the map,,,,it curious how we have opiate receptors in are bodies and when our physicall pain from a medical condition is treated effectively,our internal bodies are also happy,,like humane care equals less medical condition,,a balance in human nature if u will,,,, and ,”they did not like that fact that those terrible opiate’s actually work,i mean how dare those handicap,disabled,medically ill in physical pain human beings ,,how dare we get EQUAL living thru medicine as all those with no medical issue,,a ,”snob,” thing????Or people sooooo arrogant,they really think they have the divine rite to decide to torture and kill us???maryw

      • I think that Donald Rumsfeld’s infamous quote applies here.. Reports that say that something hasn’t happened are always interesting to me, because as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns—the ones we don’t know we don’t know. And if one looks throughout the history of our country and other free countries, it is the latter category that tends to be the difficult ones.
        There are known agendas and unknown agendas.

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