Mandatory Provider Review And Pain Clinic Laws Reduce The Amounts Of Opioids Prescribed And Overdose Death Rates

TLDR

States have enacted policies to curb inappropriate opioid prescribing, which may influence the heroin overdose epidemic by encouraging substitution or reducing concurrent use. We analyzed IMS Health’s National Prescription Audit and mortality data from 2006–13 to assess how mandated provider review of prescription drug monitoring program data and pain clinic laws impacted opioid prescribing and overdose rates. The combined policies lowered opioid prescriptions by 8 % and prescription opioid overdose deaths by 12 %, with non‑significant reductions in heroin deaths, indicating effectiveness yet highlighting the need for broader strategies.

Abstract

To address the opioid overdose epidemic in the United States, states have implemented policies to reduce inappropriate opioid prescribing. These policies could affect the coincident heroin overdose epidemic by either driving the substitution of heroin for opioids or reducing simultaneous use of both substances. We used IMS Health’s National Prescription Audit and government mortality data to examine the effect of these policies on opioid prescribing and on prescription opioid and heroin overdose death rates in the United States during 2006–13. The analysis revealed that combined implementation of mandated provider review of state-run prescription drug monitoring program data and pain clinic laws reduced opioid amounts prescribed by 8 percent and prescription opioid overdose death rates by 12 percent. We also observed relatively large but statistically insignificant reductions in heroin overdose death rates after implementation of these policies. This combination of policies was effective, but broader approaches to address these coincident epidemics are needed.