Measuring Relationships Between Proactive Reporting State-level Prescription Drug Monitoring Programs and County-level Fatal Prescription Opioid Overdoses

Cerdá, Magdalena; Ponicki, William R.; Smith, Nigel; Rivera‐Aguirre, Ariadne; Davis, Corey S.; Marshall, Brandon D.L.; Fink, David S.; Henry, Stephen G.; Castillo‐Carniglia, Álvaro; Wintemute, Garen J.; Gaidus, Andrew; Gruenewald, Paul J.; Martins, Sílvia S.

doi:10.1097/ede.0000000000001123

Cited by 43 publications

(31 citation statements)

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“…Harm reduction efforts such as expansion of naloxone access, as well as efforts to regulate opioid prescribing through prescription drug monitoring programs and pain management clinic laws, have been associated with reductions in opioid overdose deaths (107)(108)(109)(110)(111)(112). Indeed, following investment in multiple efforts to curb high risk prescribing and regulate overall opioid prescribing, prescription opioid overdose rates leveled off (although they did not decrease).…”

Section: Implications For Actionmentioning

confidence: 99%

The Opioid/Overdose Crisis as a Dialectics of Pain, Despair, and One-Sided Struggle

Friedman

Krawczyk

Perlman

et al. 2020

Front. Public Health

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The opioid/overdose crisis in the United States and Canada has claimed hundreds of thousands of lives and has become a major field for research and interventions. It has embroiled pharmaceutical companies in lawsuits and possible bankruptcy filings. Effective interventions and policies toward this and future drug-related outbreaks may be improved by understanding the sociostructural roots of this outbreak. Much of the literature on roots of the opioid/overdose outbreak focuses on (1) the actions of pharmaceutical companies in inappropriately promoting the use of prescription opioids; (2) "deaths of despair" based on the deindustrialization of much of rural and urban Canada and the United States, and on the related marginalization and demoralization of those facing lifetimes of joblessness or precarious employment in poorly paid, often dangerous work; and (3) increase in occupationally-induced pain and injuries in the population. All three of these roots of the crisis-pharmaceutical misconduct and unethical marketing practices, despair based on deindustrialization and increased occupational pain-can be traced back, in part, to what has been called the "one-sided class war" that became prominent in the 1970s, became institutionalized as neo-liberalism in and since the 1980s, and may now be beginning to be challenged. We describe this one-sided class war, and how processes it sparked enabled pharmaceutical corporations in their misconduct, nurtured individualistic ideologies that fed into despair and drug use, weakened institutions that created social support in communities, and reduced barriers against injuries and other occupational pain at workplaces by reducing unionization, weakening surviving unions, and weakening the enforcement of rules about workplace safety and health. We then briefly discuss the implications of this analysis for programs and policies to mitigate or reverse the opioid/overdose outbreak.

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Section: Implications For Actionmentioning

confidence: 99%

The Opioid/Overdose Crisis as a Dialectics of Pain, Despair, and One-Sided Struggle

Friedman

Krawczyk

Perlman

et al. 2020

Front. Public Health

Self Cite

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“…State governments have enacted an array of policy strategies to address the opioid epidemic. For instance, the creation of Prescription Drug Monitoring Program's (PDMPs), state-run electronic databases that allow prescribers, dispensers, and other health authorities to track the prescription patterns of controlled substances for individual patients, has become a widely adopted policy intervention used by states to reduce the amount of opioid painkillers prescribed to patients ( Bao et al, 2017 ; Cerdá et al, 2020 ; Fink et al, 2018 ). States have also enacted other policy interventions such as laws that aim to regulate pain management clinics, increase access to naloxone, and improve legal protections for bystanders who report drug overdoses as they are occurring.…”

Section: Introductionmentioning

confidence: 99%

The economic underpinnings of the drug epidemic

Seltzer

2020

SSM - Population Health

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U.S. labor markets have experienced transformative change over the past half century. Spurred on by global economic change, robotization, and the decline of labor unions, state labor markets have shifted away from an occupational regime dominated by the production of goods to one characterized by the provision of services. Prior studies have proposed that the deterioration of employment opportunities may be associated with the rise of substance use disorders and drug overdose deaths, yet no clear link between changes in labor market dynamics in the U.S. manufacturing sector and drug overdose deaths has been established. Using restricted-use vital registration records between 1999 and 2017 that comprise over 700,000 drug deaths, I test two questions: First, what is the association between manufacturing decline and drug and opioid overdose mortality rates? Second, how much of the increase in these drug-related outcomes can be predicted by manufacturing decline? The findings provide strong evidence that the restructuring of the U.S. labor market has played an important upstream role in the current drug crisis. Up to 92,000 overdose deaths for men and up to 44,000 overdose deaths for women are predicted by the decline of state-level manufacturing over this nearly two-decade period. These results persist in models that adjust for other social, economic, and policy trends changing at the same time. Critically, the findings signal the value of policy interventions that aim to reduce persistent economic precarity experienced by individuals and communities, especially the economic strain placed upon the middle class.

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“…92,93 Six studies found that mandatory use of PDMPs, including unsolicited and proactive reporting of patient prescription histories, improved opioid-related outcomes. [94][95][96][97][98][99] ThesepositivefindingsonstrongPDMPswere notuniform:1studyfoundnosignificantassociationbetween mandatory use requirements and the number of opioid prescriptions among patients undergoing general surgical procedures 100 and another study found that strong and weak PDMPs were associated with similar changes in opioid prescription rates, the number of cumulative doses, and prescriptionlength(indays)amongMedicarebeneficiaries. 101 Studies published after our review period investigated GoodSamaritanlaws,painclinicandmarijuanaregulations, prescribing guidelines, and educational interventions.…”

Section: Discussionmentioning

confidence: 94%

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

et al. 2020

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Objectives In the United States, rising rates of overdose deaths and recent outbreaks of hepatitis C virus and HIV infection are associated with injection drug use. We updated a 2014 review of systems-level opioid policy interventions by focusing on evidence published during 2014-2018 and new and expanded opioid policies. Methods We searched the MEDLINE database, consistent with the 2014 review. We included articles that provided original empirical evidence on the effects of systems-level interventions on opioid use, overdose, or death; were from the United States or Canada; had a clear comparison group; and were published from January 1, 2014, through July 19, 2018. Two raters screened articles and extracted full-text data for qualitative synthesis of consistent or contradictory findings across studies. Given the rapidly evolving field, the review was supplemented with a search of additional articles through November 17, 2019, to assess consistency of more recent findings. Results The keyword search yielded 535 studies, 66 of which met inclusion criteria. The most studied interventions were prescription drug monitoring programs (PDMPs) (59.1%), and the least studied interventions were clinical guideline changes (7.6%). The most common outcome was opioid use (77.3%). Few articles evaluated combination interventions (18.2%). Study findings included the following: PDMP effectiveness depends on policy design, with robust PDMPs needed for impact; health insurer and pharmacy benefit management strategies, pill-mill laws, pain clinic regulations, and patient/health care provider educational interventions reduced inappropriate prescribing; and marijuana laws led to a decrease in adverse opioid-related outcomes. Naloxone distribution programs were understudied, and evidence of their effectiveness was mixed. In the evidence published after our search’s 4-year window, findings on opioid guidelines and education were consistent and findings for other policies differed. Conclusions Although robust PDMPs and marijuana laws are promising, they do not target all outcomes, and multipronged interventions are needed. Future research should address marijuana laws, harm-reduction interventions, health insurer policies, patient/health care provider education, and the effects of simultaneous interventions on opioid-related outcomes.

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Measuring Relationships Between Proactive Reporting State-level Prescription Drug Monitoring Programs and County-level Fatal Prescription Opioid Overdoses

Cited by 43 publications

References 50 publications

The Opioid/Overdose Crisis as a Dialectics of Pain, Despair, and One-Sided Struggle

The Opioid/Overdose Crisis as a Dialectics of Pain, Despair, and One-Sided Struggle

The economic underpinnings of the drug epidemic

A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

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