Effect of FDA Warning on Codeine and Alternate Opioid Prescribing After Pediatric Dental Procedures in Ohio.

Evaluate changes in codeine and alternate opioid prescription filling after pediatric dental procedures associated with the FDA's codeine black box warning for tonsillectomy/adenoidectomy. Patients aged 0-17 years who underwent any tooth extraction or restorative procedure during August 2011-August 2016 were identified in Ohio Medicaid claims. Interrupted time series analyses were used to evaluate the impact of the FDA's warning on the rates of codeine or alternative opioid prescription fills within 14 days postprocedure. In August 2011, codeine and alternative opioid prescription fills rates after a dental procedure were 2.3 percent and 3.3 percent, respectively. These rates decreased monthly by 0.02 and 0.01 percent, respectively during the study period (P<0.0001). The FDA warning was associated with an immediate drop in codeine prescription filling of 0.4 percent (P<0.001), but there was no such association with alternative opioid prescription filling. The codeine decrease was only significant among extractions with/without concurrent restorative procedures involving males, 12- to 17-year-olds, Caucasians, and small metropolitan area residents. Opioid prescription filling after pediatric dental procedures decreased between 2011 and 2016 among Medicaid beneficiaries. In addition, there was a significant immediate reduction in codeine prescription filling after the FDA's codeine black box warning for tonsillectomy/adenoidectomy.