The Opioid Crisis: The Effects and Unintended Consequences of State Policies on Opioid Analgesic Prescribing

阿片类药物危机：国家政策对阿片类药物镇痛处方的影响和意外后果

• 批准号: 10312797
• 负责人: BRADLEY D STEIN
• 金额: $ 63.18万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-15 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10312797
• 关键词: Address; Admission activity; Affect; Behavior; Characteristics; Clinical; Communities; County; Coupled; Data; Data Set; Data Sources; Diagnosis; Disabled Persons; Disadvantaged; Drug Insurance; Drug Utilization; Health; Individual; Literature; Medical; Medicare; Medicare claim; Mental Health; Monitor; Oncology; Operative Surgical Procedures; Opioid; Opioid Analgesics; Outcome; Overdose; Pain Clinics; Pain management; Patients; Pattern; Pharmaceutical Preparations; Pharmacy facility; Policies; Population; Public Health; Recording of previous events; Regulation; Risk; Rural; Rural Community; Societies; Substance Use Disorder; Therapeutic; Touch sensation; Variant; beneficiary; design; ethnic minority; ethnic minority population; experience; federal policy; high risk population; opioid abuse; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; opioid use; patient population; practice setting; prescription drug abuse; prescription monitoring program; prescription opioid; prescription pain reliever; prior authorization; programs; racial and ethnic; response; rural area; socioeconomic disadvantage; surgical pain

Project Summary The U.S. is facing an opioid-related public health crisis, and states have responded with a range of policies and initiatives, many of which are intended to decrease the widespread availability of opioid analgesics. Our understanding of the impact of these policies is still evolving, results of studies have been mixed, and no studies have examined to what extent policies have decreased potentially inappropriate prescribing while leaving likely appropriate prescribing untouched. To assess the impact of state policies and initiatives on overall opioid prescribing rates, likely appropriate prescribing, and potentially inappropriate prescribing, this project will produce empirical findings addressing these gaps using Medicare claims data for disabled beneficiaries, as well as IQVIA data which covers an estimated 88% of prescriptions filled at U.S. pharmacies. It will also examine how policies affect opioid prescription fills for historically underserved and high-risk populations. The results will inform state policymaking efforts related to the opioid crisis.

项目摘要 美国正面临与阿片类药物有关的公共卫生危机，各州已采取一系列政策予以应对， 这些举措中有许多旨在减少类阿片镇痛剂的广泛供应。我们 对这些政策影响的了解仍在不断发展，研究结果好坏参半，而且没有 研究已经检查了政策在多大程度上减少了潜在的不适当处方， 留下可能合适的处方未被触及。评估国家政策和举措对 总体阿片类药物处方率，可能适当的处方和可能不适当的处方，这 该项目将利用残疾人医疗保险索赔数据，得出解决这些差距的实证研究结果 受益人，以及IQVIA数据，其中涵盖了美国药店约88%的处方。 它还将研究政策如何影响阿片类药物处方填补历史上服务不足和高风险 人口。结果将为与阿片类药物危机有关的国家政策制定工作提供信息。

项目成果

Urine drug testing in the context of opioid analgesic prescribing for chronic pain: a content analysis of U.S. state laws in 2022.

慢性疼痛阿片类镇痛处方背景下的尿液药物检测：2022 年美国各州法律的内容分析。

• DOI: 10.1093/pm/pnad103
• 发表时间: 2023
• 期刊: Pain medicine (Malden, Mass.)
• 作者: Andraka-Christou,Barbara;McAvoy,Elizabeth;Gordon,AdamJ;Ohama,Maggie;Brach,Marilyn;Taylor,ErinA;Vaiana,Mary;Saloner,Brendan;Stein,BradleyD
• 通讯作者: Stein,BradleyD

A National Retrospective Study of Antidepressants' Effects on Overdose and Self-Harm Among Adults Treated With Opioid Analgesics.

一项关于抗抑郁药对接受阿片类镇痛药治疗的成年人服用过量和自我伤害的影响的全国回顾性研究。

• DOI: 10.1176/appi.ps.20220070
• 发表时间: 2023
• 期刊: Psychiatric services (Washington, D.C.)
• 作者: Sherry,TisamarieB;Nguyen,Thuy;Dick,AndrewW;Bradford,AshleyC;Simon,Kosali;Stein,BradleyD
• 通讯作者: Stein,BradleyD