Laws limiting prescribing and dispensing of opioids in the United States, 1989-2019
Laws limiting prescribing and dispensing of opioids in the United States, 1989-2019
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DOI：
10.1111/add.15359
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发表时间：
2021-01-18
期刊：
影响因子：
6
通讯作者：
Lieberman, Amy Judd
中科院分区：
文献类型：
--
作者：
Davis, Corey S.;Lieberman, Amy Judd
背景和目的阿片类药物过量在美国是一种公共卫生紧急情况。为了减少可能不适当的阿片类药物处方，美国许多州已经通过了法律的限制，限制医疗专业人员处方或分发阿片类药物治疗疼痛的能力。本综述描述了相关美国州法律的主要要素以及它们随着时间的推移而发生变化的方式。方法系统性的法律的审查，其中两名训练有素的法律的研究人员收集并审查了所有限制医疗专业人员可能开出或分发用于疼痛的阿片类药物的数量或持续时间的美国州法律。这些法律然后被编码在一组预先选择的措施，包括当法律颁布，剂量和持续时间的限制，限制不适用的情况下，以及是否额外的要求或限制适用于处方未成年人。结果美国的数量与阿片类药物限制法律从10个在2016年增加到39个到2019年底。这些法律的规定因州而异，并随着时间的推移而在州内发生变化。截至2019年底，模式持续时间限制为7天，范围为3至31天。14个州对阿片类药物的剂量进行了限制，从30毫克吗啡当量（MME）到每日最大120 MME。结论2016年至2019年，美国有阿片类药物限制法律的州数几乎翻了两番，各州限制和变化之间存在很大的异质性。
Background and Aims Opioid overdose is a public health emergency in the United States. In an attempt to reduce potentially inappropriate opioid prescribing, many US states have adopted legal restrictions on the ability of medical professionals to prescribe or dispense opioids for pain. This review describes the major elements of relevant US state laws and the ways in which they have changed over time.Methods Systematic legal review in which two trained legal researchers collected and reviewed all US state laws that limit the amount or duration of opioids that medical professionals may prescribe or dispense for pain. These laws were then coded on a set of pre-selected measures, including when the law was enacted, dosage and duration limits imposed, circumstances in which the restrictions do not apply and whether additional requirements or restrictions apply to prescriptions issued to minors.Results The number of US states with opioid limitation laws increased from 10 in 2016 to 39 by the end of 2019. The provisions of these laws vary between states and have shifted within states over time. At the end of 2019 the modal duration limit was 7 days, with a range of 3 to 31. Fourteen states imposed limits on the dosage of opioids that can be prescribed, ranging from 30 morphine milligram equivalents (MME) to a 120 MME daily maximum. In 16 states, different limits apply to prescriptions issued to minors.Conclusions The number of US states with opioid limitation laws nearly quadrupled between 2016 and 2019, with a great amount of heterogeneity between state restrictions and changes over time.