Network for Public Health Law, Los Angeles, California.
Brody School of Medicine, East Carolina University, Greenville, North Carolina.
Pain Med. 2020 Mar 1;21(3):532-537. doi: 10.1093/pm/pnz159.
To determine whether the adoption of laws that limit opioid prescribing or dispensing is associated with changes in the volume of opioids distributed in states.
State-level data on total prescription opioid distribution for 2015-2017 were obtained from the US Drug Enforcement Administration. We included in our analysis states that enacted an opioid prescribing law in either 2016 or 2017. We used as control states those that did not have an opioid prescribing law during the study period. To avoid confounding, we excluded from our analysis states that enacted or modified mandates to use prescription drug monitoring programs (PDMPs) during the study period. To estimate the effect of opioid prescription laws on opioid distribution, we ran ordinary least squares models with indicators for whether an opioid prescription law was in effect in a state-quarter. We included state and quarter fixed effects to control for time trends and time-invariant differences between states.
With the exception of methadone and buprenorphine, the amount of opioids distributed in states fell during the study period. The adoption of opioid prescribing laws was not associated with additional decreases in opioids distributed.
We did not detect an association between adoption of opioid prescribing laws and opioids distributed. States may instead wish to pursue evidence-based efforts to reduce opioid-related harm, with a particular focus on treatment access and harm reduction interventions.
确定限制阿片类药物处方或配药的法律的通过是否与各州分发的阿片类药物数量的变化有关。
从美国毒品执法局获得了 2015-2017 年总处方类阿片药物分发的州级数据。我们将在 2016 年或 2017 年颁布阿片类药物处方法律的州纳入我们的分析。我们将在研究期间没有阿片类药物处方法律的州作为对照州。为避免混淆,我们排除了在研究期间颁布或修改使用处方药物监测计划(PDMP)的州。为了估计阿片类药物处方法律对阿片类药物分发的影响,我们在州季度是否存在阿片类药物处方法律的指标上运行普通最小二乘法模型。我们包括州和季度固定效应,以控制时间趋势和各州之间的时间不变差异。
除美沙酮和丁丙诺啡外,各州分发的阿片类药物数量在研究期间有所下降。采用阿片类药物处方法律并没有导致分发的阿片类药物进一步减少。
我们没有发现阿片类药物处方法律的通过与分发的阿片类药物之间存在关联。各州可能希望转而采取基于证据的努力来减少阿片类药物相关的伤害,特别关注治疗机会和减少伤害干预措施。