title: Mandatory Provider Review And Pain Clinic Laws Reduce The Amounts Of Opioids Prescribed And Overdose Death Rates.
abstract: To address the opioid overdose epidemic in the United States, states have implemented policies to reduce inappropriate opioid prescribing. These policies could affect the coincident heroin overdose epidemic by either driving the substitution of heroin for opioids or reducing simultaneous use of both substances. We used IMS Health's National Prescription Audit and government mortality data to examine the effect of these policies on opioid prescribing and on prescription opioid and heroin overdose death rates in the United States during 2006-13. The analysis revealed that combined implementation of mandated provider review of state-run prescription drug monitoring program data and pain clinic laws reduced opioid amounts prescribed by 8 percent and prescription opioid overdose death rates by 12 percent. We also observed relatively large but statistically insignificant reductions in heroin overdose death rates after implementation of these policies. This combination of policies was effective, but broader approaches to address these coincident epidemics are needed.
authors.affiliation: Deborah Dowell (gdo7@cdc.gov) is a senior medical advisor at the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Dowell
authors.affiliation: Kun Zhang is a health economist and senior service fellow at the National Center for Injury Prevention and Control, CDC.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Rita K. Noonan is chief of the Health Systems and Trauma Systems Branch of the National Center for Injury Prevention and Control, CDC.
authors.forename: Rita K
authors.initials: RK
authors.lastname: Noonan
authors.affiliation: Jason M. Hockenberry is an associate professor in the Department of Health Policy and Management at Emory University, in Atlanta.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Hockenberry
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D002423:Cause of Death / Q000639:trends*; D062787:Drug Overdose / Q000453:epidemiology*; D058872:Epidemics; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D018710:Pain Clinics / Q000331:legislation & jurisprudence*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D063487:Prescription Drug Misuse; D014481:United States
chemical_list: D000701:Analgesics, Opioid
keywords: Epidemiology; Medicine/Clinical Issues; Pharmaceuticals; Public Health