Clinical AdvisorArtificial Intelligence May Influence Whether You Can Get Pain Medication

As AI Algorithms Monitor Opioid Prescriptions, Questions Arise About Accuracy, Bias, and Unintended Consequences

In an era where artificial intelligence is increasingly integrated into healthcare, AI-driven tools like Narx Scores are being used to monitor opioid prescriptions. Although these systems aim to combat the opioid crisis, they also raise concerns about their accuracy, potential bias, and the lack of transparency in their algorithms. The stakes are high for both patients and physicians, as these tools can significantly influence medical decisions and patient care.

HCN Medical Memo
The growing use of AI-driven opioid monitoring systems like Narx Scores presents both an opportunity and a challenge. Although these tools can aid in identifying potential misuse of opioids, it’s crucial to be aware of their limitations and the lack of transparency in how they work. Relying solely on these scores could lead to unintended consequences such as denying patients necessary medication or even jeopardizing your medical license. As healthcare professionals, we must advocate for more transparent and accurate systems while balancing the need to address the opioid crisis effectively.

Key Points

• Narx Scores are generated by Bamboo Health’s NarxCare platform to help medical providers review controlled substance prescriptions.
• The platforms draw on state-collected data about prescriptions for controlled substances, but the algorithms behind them are not publicly disclosed.
• Some patients, like Elizabeth Amirault, say they have been unfairly denied medication due to high Narx Scores, affecting their quality of care.
• Physicians have also reported being flagged by these systems, leading to legal repercussions and loss of medical licenses.
• Health economist Jason Gibbons warns that these technologies may not be working as intended and could be causing harm.

“We need to see what’s going on to make sure we’re not doing more harm than good.”
– Jason Gibbons, a health economist at the Colorado School of Public Health at the University of Colorado’s Anschutz Medical Campus

Additional Points

• The Centers for Disease Control and Prevention (CDC) advises clinicians to consult Prescription Drug Monitoring Programs (PDMPs) but warns against harmful usage.
• More than 40 states use technology from Bamboo Health for their PDMPs.
• Other companies like Qlarant have developed similar algorithms, but these have also not been independently peer-reviewed.
• The American Medical Association has expressed concern over the immediate suspension of physicians’ prescribing privileges due to these algorithms.

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