Laws limiting the prescribing or dispensing of opioids for acute pain in the United States: A national systematic legal review.

@article{Davis2019LawsLT,
  title={Laws limiting the prescribing or dispensing of opioids for acute pain in the United States: A national systematic legal review.},
  author={Corey S. Davis and Amy Judd Lieberman and Hector Hernandez-Delgado and Carli Suba},
  journal={Drug and alcohol dependence},
  year={2019},
  volume={194},
  pages={
          166-172
        }
}
Laws limiting prescribing and dispensing of opioids in the United States, 1989-2019.
TLDR
The number of US states with opioid limitation laws nearly quadrupled between 2016 and 2019, with a great amount of heterogeneity between state restrictions and changes over time.
Evaluating Consequences of Opioid Prescribing Policies
  • E. Krebs
  • Medicine
    Journal of General Internal Medicine
  • 2020
TLDR
Evaluated effects of a New Jersey law that restricts all new opioid prescriptions for acute pain to 5 days in duration concluded that the law plus EMR alert implementation was associated with reduced opioid prescribing, without evidence of unintended consequences.
Effects of State Opioid Prescribing Laws on Use of Opioid and Other Pain Treatments Among Commercially Insured U.S. Adults
TLDR
This study did not identify changes in opioid prescribing or nonopioid pain treatment attributable to state laws, and results may not be generalizable to non-commercially insured populations and were imprecise for some estimates.
Opioid and non-opioid analgesic prescribing before and after the CDC’s 2016 opioid guideline
TLDR
A theory of physician prescribing behavior under this two-pronged incentive structure is developed and empirically corroborate the theory: regulations and guidelines have the intended effects of reducing opioid prescriptions for acute and chronic pain, respectively, as well as the predicted unintended effects.
Opioid Prescribing Limits and Opioid-Related Mortality
TLDR
Initial findings suggest that opioid prescribing limits decrease the death rate from heroin overdoses and semisynthetic opioid overdoses, like from Oxycodone and Hydrocodone, by 0.09 per 100,000 people per month within a year, decreases of about 35% and 45% from the pre-treatment means, respectively.
Changes in Quantity of Opioids Dispensed following Florida’s Restriction Law for Acute Pain Prescriptions
TLDR
The immediate reduction in new opioid utilization following policy implementation suggests effective policy; however, impacts on chronic pain patients were not assessed.
Characteristics of Opioid Prescribing in Non-surgical Medicine Patients with Acute Pain at Hospital Discharge
TLDR
Standardized indication-based opioid prescribing guidance in the non-surgical medical population would help curb the amount of opioids that remain unused post-discharge, observed variation in opioid prescribing and utilization data.
Prescription Patterns of Adjuvant Pain Medications Following an Opioid Supply Restriction Law
TLDR
An increased number of patients and prescriptions were observed for gabapentinoids, while fewer patients received benzodiazepines and muscle relaxants after HB21, suggesting that these laws may also have unintended consequences for the use of adjunctive medications that were not intended to be affected.
Impact of Opioid Restriction Legislation on Prescribing Practices for Outpatient Plastic and Reconstructive Surgery
TLDR
Evidence is provided that legislation at the state level restricting postoperative opioid prescriptions is associated with a decrease in opioid prescriptions without an increase in the need for refills in the acute postoperative setting following outpatient plastic surgery procedures.
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TLDR
This guideline is intended to improve communication about benefits and risks of opioids for chronic pain, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy.
An analysis of the root causes for opioid-related overdose deaths in the United States.
TLDR
Clinical strategies to reduce opioid-related mortality should be empirically tested, should not reduce access to needed therapies, should address risk from methadone as well as other opioids, and should be incorporated into any risk evaluation and mitigation strategies enacted by regulators.
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A review of the current literature about monitoring of opioid adherence found not a single screening tool that can be applied universally to all patients who are on opioid therapy for chronic non-cancer pain.
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Despite reductions in opioid prescribing in some parts of the country, the amount of opioids prescribed remains high relative to 1999 levels and varies substantially at the county-level, and health care providers should carefully weigh the benefits and risks when prescribing opioids.
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TLDR
Early opioid prescribing patterns are associated with long-term use among opioid-naïve patients and clinicians have greater control over initial prescribing, and findings may help minimize the risk of inadvertently initiating long- term opioid use.
Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis
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Although significant variability remains in this literature, this review provides guidance regarding possible average rates of opioid misuse and addiction and also highlights areas in need of further clarification.
Opioid Poisonings in Washington State Medicaid: Trends, Dosing, and Guidelines
TLDR
Examining changes in rates of methadone and other opioid poisonings after implementation of the WA State Opioid Guideline in 2007 and the prescription history before poisonings found that it may be prudent to revise guidelines to address opioid Poisonings occurring at relatively low prescribed doses and with acute and intermittent opioid use.
Opioid Prescribing Patterns, Patient Use, and Postoperative Pain After Hysterectomy for Benign Indications.
TLDR
The best fit model of total opioid consumption identified preoperative Fibromyalgia Survey Score, overall body pain, preoperative opioid use, prior endometriosis, abdominal hysterectomy, and uterine weight as significant predictors of postsurgical opioid use and pain recovery.
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