Detecting Anomalous Networks of Opioid Prescribers and Dispensers in Prescription Drug Data

Abstract The opioid overdose epidemic represents a serious public health crisis, with fatality rates rising considerably over the past several years. To help address the abuse of prescription opioids, state governments collect data on dispensed prescriptions, yet the use of these data is typically limited to manual searches. In this paper, we propose a novel graph-based framework for detecting anomalous opioid prescribing patterns in state Prescription Drug Monitoring Program (PDMP) data, which could aid governments in deterring opioid diversion and abuse. Specifically, we seek to identify connected networks of opioid prescribers and dispensers who engage in high-risk and possibly illicit activity. We develop and apply a novel extension of the Non-Parametric Heterogeneous Graph Scan (NPHGS) to two years of de-identified PDMP data from the state of Kansas, and find that NPHGS identifies subgraphs that are significantly more anomalous than those detected by other graph-based methods. NPHGS also reveals clusters of potentially illicit activity, which may strengthen state law enforcement and regulatory capabilities. Our paper is the first to demonstrate how prescription data can systematically identify anomalous opioid prescribers and dispensers, as well as illustrating the efficacy of a network-based approach. Additionally, our technical extensions to NPHGS offer both improved flexibility and graph density reduction, enabling the framework to be replicated across jurisdictions and extended to other problem domains.