State limits on initial time to take opioids can affect prescribing

HealthDay News – State laws restricting initial opioid prescribing times have linked opioid prescribing changes, according to a research letter published online Aug. 9 in JAMA Internal Medicine.

John D. Cramer, MD, of Wayne State University in Detroit, and colleagues evaluated the impact of laws enacted in 23 states (March 2016 through July 2018) to limit initial opioid prescriptions to a maximum of seven days limit (17 states: no more than seven days; two states: no more than five days; four states: no more than three days). The Medicare Part D Prescriber Public Use File (2013-2018) was used to identify opioid prescriptions.

The researchers found that the average number of days opioid was prescribed per participant decreased by an average of 11.6 days in duration-restricted states, versus an average decrease of 10.1 days in control states. The number of opioid days prescribed was similar in restricted and non-restricted states before restrictions were introduced in 2016. State laws limiting opioid prescribing to no more than seven days were linked to a 1.7 days reduction in opioid prescribing per participant in a fitted analysis. The largest drop in opioid prescribing was seen among primary care physicians, although this finding was not significantly different from the control states in the states exposed to the policy. However, there has been a significant decrease in opioid prescriptions from surgeons and dentists, pain and other specialists in states with lengthy prescription laws.

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“The decline in opioid prescribing has occurred in policy-exposed states and control states, suggesting that either state laws have influenced prescribing behavior across state lines, or that this legislation is just one of many measures that have done so helped reduce opioid prescribing, ”the authors write.

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