The association of state policies and opioid analgesic amount dispensed from retail pharmacies

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-02-01 DOI:10.1016/j.drugalcdep.2024.112533

Bradley D. Stein , Flora Sheng , Erin A. Taylor , Corey S. Davis , Beth Ann Griffin , Mark Sorbero , Andrew W. Dick

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引用次数: 0

Abstract

Importance

States have implemented multiple policies likely to influence opioid prescribing; few national general population studies examine those policies’ effects on per-capita opioid morphine milligram equivalents (MME) dispensed.

Objective

To examine state policies’ effects on opioids per-capita MMEs dispensed at retail pharmacies.

Design

A longitudinal study of associations between MME per capita and implementation of policy interventions at different times across states.

Setting

United States, 2006–2018

Patients

Data representing approximately 90 % of prescriptions filled at retail pharmacies in the United States.

Interventions

States implementing (1) Pain management clinic laws, (2) operational Prescription Drug Monitoring Programs (PDMP), (3) mandatory PDMP use, (4) required continuing medical education for opioid prescribers, (5) medical cannabis dispensary laws, and (6) initial prescription duration limit laws.

Main outcomes and measurements

Monthly county-level opioid MME per-capita.

Results

Pain management clinic policies’ effects were modest, not significantly associated with MME per-capita in the year following implementation, but negatively associated in subsequent years. Operational PDMP policies were negatively associated with MME per-capita in all five years following implementation. We found no evidence of significant effects of mandatory PDMP requirements, mandatory continuing medical education policies, or medical cannabis dispensary policies in any of the five years following policy implementation. Initial prescription duration limits were associated with increased per-capita MME dispensed in years 3–5 following implementation.

Conclusions and relevance

Several state policies are associated with reductions in the total amount of opioid analgesic dispensed. Additional research should examine the policies’ effects on clinical outcomes in both general and high-risk populations.

查看原文本刊更多论文

国家政策与阿片类镇痛药零售药房配药量的关系。

重要性：各国实施了可能影响阿片类药物处方的多项政策；很少有国家一般人口研究检查这些政策对分配的人均阿片类吗啡毫克当量（MME）的影响。目的：考察国家政策对零售药店阿片类药物人均mme的影响。设计：对各州不同时期人均MME与政策干预实施之间的关系进行纵向研究。环境：美国，2006-2018年患者：数据代表了美国零售药店约90%的处方。干预措施：各州实施(1)疼痛管理诊所法，(2)操作性处方药监测计划（PDMP），(3)强制使用PDMP，(4)要求阿片类药物处方者接受继续医学教育，(5)医用大麻药房法，(6)初始处方持续时间限制法。主要结果和测量：每月县级人均阿片类药物MME。结果：临床疼痛管理政策的效果是适度的，在实施后一年与人均MME无显著相关，但在随后的年份呈负相关。在实施后的所有五年中，可操作的PDMP政策与人均MME呈负相关。在政策实施后的五年中，我们没有发现强制性PDMP要求、强制性继续医学教育政策或医用大麻药房政策有显著影响的证据。初始处方期限限制与实施后3-5年人均MME分配增加有关。结论和相关性：一些国家政策与阿片类镇痛药分配总量的减少有关。进一步的研究应该检查这些政策对一般人群和高危人群临床结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.