Comparison of opioid prescribing patterns in the United States and Japan: Primary care physicians' attitudes and perceptions

Eriko Onishi, Tadashi Kobayashi, Eve Dexter, Miguel Marino, Tetsuhiro Maeno, Richard A. Deyo

Research output: Contribution to journalReview articlepeer-review

62 Scopus citations


Introduction: Far fewer opioids are prescribed in Japan than in the United States. Methods: We conducted an online physician survey assessing attitudes and perceptions that might influence prescribing. A Japanese version was distributed to members of the Japan Primary Care Association and an English version to members of the American Academy of Family Physicians practicing in Oregon. Results: We received 461 Japanese responses and 198 from the United States, though overall response rates were low (Japan: 10.1%, United States: 18.5%). Japanese respondents reported far less opioid prescribing than US respondents, especially for acute pain (acute pain: 49.4% vs 97.0%; chronic pain: 63.7% vs 90.9%; P < .001 for both). Almost half of respondents from both countries indicated that patient expectations and satisfaction were important factors that influence prescribing. US respondents were significantly more likely to identify medical indication and legal expectation as reasons to prescribe opioids for acute pain. Most US respondents (95.4%) thought opioids were used too often, versus 6.6% of Japanese respondents. Conclusions: Lower opioid use was reported in Japan, especially for acute pain, which may help minimize long-term use. Patient expectations and satisfaction seem to influence opioid prescribing in both countries. The United States could learn from Japanese regulatory and cultural perspectives.

Original languageEnglish (US)
Pages (from-to)248-254
Number of pages7
JournalJournal of the American Board of Family Medicine
Issue number2
StatePublished - Mar 1 2017


  • Acute Pain
  • Chronic Pain
  • Japan
  • Opioid Analgesics
  • Opioid-Related Disorders
  • Oregon
  • Prescriptions
  • Primary Health Care
  • Surveys and Questionnaires

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


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