State prescribing cap laws' association with opioid analgesic prescribing and opioid overdose. (1st November 2022)

• Record Type: Journal Article
• Authors: Tormohlen, Kayla N.; McCourt, Alex D.; Schmid, Ian; Stone, Elizabeth M.; Stuart, Elizabeth A.; Davis, Corey; Bicket, Mark C.; McGinty, Emma E.
• Is Part Of: Drug and alcohol dependence. Volume 240(2022)
• Publication Date: 2022-11-01
• Subjects: Opioid prescribing -- Opioid overdose -- State policy; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2022.109626
• Languages: English
• ISSNs: 0376-8716

Abstract

Abstract: Introduction: In response to the role of opioid prescribing in the U.S. opioid crisis, states have enacted laws intended to curb high risk opioid prescribing practices. This study assessed the effects of state prescribing cap laws that limit the dose and/or duration of dispensed opioid prescriptions on opioid prescribing patterns and opioid overdose. Methods: We identified 1, 414, 908 adults from a large U.S. administrative insurance claims database. Treatment states included 32 states that implemented a prescribing cap law between 2017 and 2019. Comparison states included 16 states and DC without a prescribing cap law by 2019. A difference-in-differences approach with staggered policy adoption was used to assess effects of these laws on opioid analgesic prescribing and opioid overdose. Results: State opioid prescribing cap laws were not associated with changes in the proportion of people receiving opioid analgesic prescriptions, the dose or duration of opioid prescriptions, or opioid overdose. States with laws that imposed days' supply limits only versus days' supply and dosage limits, as well as with specific law provisions also showed no association with opioid prescribing or opioid overdose outcomes. Conclusions: State opioid prescribing cap laws did not appear to impact outcomes related to opioid analgesic prescribing or opioid overdose. These findings are potentially due to the limited scope of these laws, which often apply only to a subset of opioid prescriptions and include professional judgment exemptions. Highlights: Over the past decade, a growing number of states have enacted a prescribing cap law. Opioid prescribing cap laws are not associated with changes in opioid prescribing. State prescribing cap laws did not impact opioid overdose outcomes.