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Study: States’ Prescribing Laws Not Impacting Opioid Availability for Chronic Pain Patients
State laws intended to address prescription opioid misuse by limiting prescribing practices were found to have no actual effect on prescribing patterns for adults who are commercially insured or those with chronic, noncancer pain, according to a study released this week by the Johns Hopkins Bloomberg School of Public Health.
Findings were published in the Annals of Internal Medicine.
In response to concerns that the opioid overdose crisis was being fueled by overprescribing of pain medications, states since 2010 have passed various laws to reduce prescribing, including legislation that limits doses and durations, as well laws that regulate opioid dispensing by pain management clinics. Some within the field have expressed concerns that such restrictions could negatively impact chronic pain patients by restricting their access to medications without sufficient nonopioid alternatives.
The Johns Hopkins researchers looked at 13 states that have passed laws related to the following areas since 2010:
- Opioid prescribing limits
- Regulation of pain management clinics (“pill mill” laws)
- Mandatory prescription drug monitoring database checks before prescribing
- Mandatory prescription drug monitoring database enrollment by prescribers
Researchers looked at opioid prescribing patterns in the 13 states in the 2 years before and after their laws’ passage. Using insurance claims data from a national insurance claims database, the study found state laws were associated with a less than 1% change in the proportion of patients receiving an opioid prescription and a less than 2% change in patients receiving nonopioid pain treatments. For patients receiving opioid prescriptions, state laws were associated with less than a day’s difference in opioid quantities prescribed and saw no significant changes in dosage practices.
“While trends in the volume of prescriptions have been steadily declining over the last decade, our study suggests that those declines have not been driven by state opioid prescribing laws,” Beth McGinty, PhD, MS, professor in the Department of Health Policy and Management and co-director of the Center for Mental Health and Addiction Policy Research at the Bloomberg School, said in a news release. “The findings suggest that the decline in opioid prescribing may be driven more by shifting clinical guidance, changing professional norms, or other factors.”
References
McGinty EE, Bicket MC, Seewald NJ, et al. Effects of state opioid prescribing laws on use of opioid and other pain treatments among commercially insured U.S. adults. Ann Intern Med. Published online March 15, 2022. doi:10.7326/m21-4363
