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August 27, 2015
Florida Laws Reduced Opioid Prescribing in Year
After Implementation Baltimore—Can better control of opioid prescriptions be legislated? The effect of two Florida laws, enacted to combat prescription drug abuse and misuse in that state, suggest the answer is “yes.” A study published online recently by JAMA Internal Medicine reports a small but significant decrease in the amount of opioids prescribed the first year after the laws were enacted. One of the legislative actions created a Prescription Drug Monitoring Program to track individual prescriptions, including patient names, dates, and amounts prescribed. The other measure took on so-called “pill mills,” requiring the pain clinics, which under looser regulation often had disproportionately high levels of opioid prescriptions, to register with the state and be owned by a physician. The study, led by researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore, found that Florida’s opioid prescriptions dropped 1.4% and the volume of opioids decreased 2.5% in the year after the laws were implemented, compared to prescribing patterns in neighboring Georgia. At the same time, the amount per prescription declined 5.6%, also compared with Georgia, with the greatest declines among the heaviest users and prescribers, study authors note. “These findings support the notion that there are policy solutions to the prescription drug epidemic,” lead author Lainie Rutkow, JD, MPH, PhD, suggested in a Johns Hopkins press release. Before the new laws went into effect, Florida, in line with the rest of the United States, saw prescription-drug overdose deaths rising significantly. In Florida, those deaths increased more than 80% between 2003 and 2009. Now, all 50 states and the District of Columbia currently have drug-monitoring programs in place, with at least a dozen beginning to regulate pain-management clinics. For the analysis using prescription data from IMS Health LifeLink LRx, researchers compared opioid prescriptions in Florida with those in Georgia, which did not yet have comparable programs in place, for the 12 months before and after the two policies were implemented in the summer of 2011: July 2010 through June 2011 and October 2011 through September 2012. Nearly 37 million opioid prescriptions were reviewed in the two states. Examined in the study were total opioid volume prescribed per month; the average dosage, or morphine milligram equivalent, per transaction; the average days’ supply per transaction; and the total number of prescriptions. “To curb epidemic rates of prescribing, morbidity and mortality associated with opioid misuse and diversion, states have spent millions of dollars implementing policies designed to reduce excessive dispensing of these products,” study authors note. “Paramount to these efforts are studies empirically testing these policies’ effectiveness and a growing evidence base informing policy makers of the benefits and harms that may result. Our study adds to this evidence base and, using pharmacy claims, shows that implementation of Florida’s PDMP and pill mill law was associated with modest decreases in opioid use and prescribing among patients and providers with high levels of opioid use at baseline relative to Georgia, a comparison state.”
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