Opioid Prescribing Laws Are Not Associated with Short-term Declines in Prescription Opioid Distribution
Opioid Prescribing Laws Are Not Associated with Short-term Declines in Prescription Opioid Distribution
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DOI：
10.1093/pm/pnz159
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发表时间：
2020-03-01
期刊：
影响因子：
3.1
通讯作者：
Rotter, Jason S.
中科院分区：
文献类型：
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作者：
Davis, Corey S.;Piper, Brian J.;Rotter, Jason S.
Objective.确定限制阿片类药物处方或分发的法律的通过是否与各州阿片类药物分发量的变化有关。方法. 2015-2017年处方阿片类药物总分布的州一级数据来自美国缉毒局。我们的分析包括在2016年或2017年颁布阿片类药物处方法的国家。我们使用那些在研究期间没有阿片类药物处方法的国家作为对照。为了避免混淆，我们从分析中排除了在研究期间颁布或修改了使用处方药监测计划（PDMP）的国家。为了估计阿片类药物处方法对阿片类药物分布的影响，我们运行了普通最小二乘模型，其中包含阿片类药物处方法是否在州季度生效的指标。我们包括了状态和季度固定效应，以控制状态之间的时间趋势和时不变差异。结果除美沙酮和丁丙诺啡外，在研究期间，各州分发的阿片类药物数量有所下降。类阿片处方法的通过与类阿片分销量的进一步减少无关。结论.我们没有发现阿片类药物处方法的采用与阿片类药物的分布之间存在关联。相反，各国不妨开展循证努力，减少类阿片相关危害，特别侧重于治疗的获得和减少危害的干预措施。
Objective. 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. Methods. 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. Results. 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. Conclusions. 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.