Opioid Prescribing Laws Are Not Associated with Short-term Declines in Prescription Opioid Distribution

Davis, Corey S.; Piper, Brian J.; Gertner, Alex K.; Rotter, Jason

doi:10.1093/pm/pnz159

Cited by 47 publications

(46 citation statements)

References 24 publications

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“…23 The rapid population growth in Texas may have delayed the temporal inflection point when more cautious opioid use for chronic non-cancer pain became evident. These findings can be contrasted with other ARCOS opioid reports from Arkansas, 26 Colorado, 27 Delaware, 21,24 Florida, 16 Hawaii, 16,24 Indiana, 21,24 Kentucky 21,24 , Louisiana, 26 Maine, 25,28 Maryland, 24,27 Michigan, 21,27 Minnesota 24 , Nevada, 24 New Jersey, 21,24 New Mexico, # New York, 24 Ohio, 21 Oklahoma, 26 Pennsylvania, 21,25 Utah, 27 Vermont, 24 Washington, 29 West Virginia, 21,30 and the US Territories. 16 Texas showed some parallels with the rest of the US when examining individual agents but also some differences.…”

Section: Discussioncontrasting

confidence: 76%

“…Future studies should evaluate whether state laws requiring checking the Texas PMP or a tenday prescribing limit for acute pain achieves its desired objectives. 24,25,[45][46][47]…”

Section: Discussionmentioning

confidence: 99%

“…Manuscript to be reviewed problems with non-prescribed opioids. Further national policy research24,25 is necessary to examine how variations in health insurance, including Medicaid expansion, may be associated with pharmacoepidemiological differences in the long-term treatment of pain or opioid misuse.Thereare some strengths and limitations to this report and caveats of this data. ARCOS is a comprehensive data source in terms of including diverse patient groups often omitted from other studies and is publically available.…”

mentioning

confidence: 99%

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Peer Review #1 of "Dynamic changes in prescription opioids from 2006 to 2017 in Texas (v0.1)"

2019

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Background. The US is experiencing an epidemic of opioid overdoses which may be at least partially due to an over-reliance on opioid analgesics in the treatment of chronic non-cancer pain and subsequent escalation to heroin or illicit fentanyl. As Texas was reported to be among the lowest in the US for opioid use and misuse, further examination of this state is warranted. Materials and Methods. This study was conducted to quantify prescription opioid use in Texas. Data was obtained from the publically available US Drug Enforcement Administration's Automation of Reports and Consolidated Orders System (ARCOS) which monitors controlled substances transactions from manufacture to commercial distribution. Data for 2006-2017 from Texas for ten prescription opioids including eight primarily used to relieve pain (codeine, fentanyl, hydrocodone, hydromorphone, meperidine, morphine, oxycodone, oxymorphone) and two (buprenorphine and methadone) for the treatment of an Opioid Use Disorder (OUD) were examined. Results. The change in Morphine Mg Equivalent (MME) of all opioids (+23.3%) was only slightly greater than the state's population gains (21.1%). Opioids used to treat an OUD showed pronounced gains (+90.8%) which were four-fold faster than population growth. Analysis of individual agents revealed pronounced elevations in codeine (+387.5%), hydromorphone (+106.7%), and oxycodone (+43.6%) and a reduction in meperidine (-80.3%) in 2017 relative to 2006. Methadone in 2017 accounted for a greater portion (39.5%) of the total MME than hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, and meperidine, combined. There were differences between urban and rural areas in the changes in hydrocodone and buprenorphine. Conclusions. Collectively, these findings indicate that continued vigilance is needed in Texas to appropriately treat pain and an OUD while minimizing the potential for prescription opioid diversion and misuse. Texas may lead the US in a return to pre opioid epidemic prescription levels.

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Section: Discussioncontrasting

confidence: 76%

“…Future studies should evaluate whether state laws requiring checking the Texas PMP or a tenday prescribing limit for acute pain achieves its desired objectives. 24,25,[45][46][47]…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Peer Review #1 of "Dynamic changes in prescription opioids from 2006 to 2017 in Texas (v0.1)"

2019

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“…The rapid population growth in Texas may have delayed the temporal inflection point when more cautious opioid use for chronic non-cancer pain became evident. These findings can be contrasted with other ARCOS opioid reports from Arkansas (Sahota & Boyle, 2019), Colorado (Kropp et al, 2019), Delaware (Feickert et al, 2019; Davis et al, in press), Florida (Cabera et al, 2018), Hawaii (Cabera et al, 2018; Davis et al, in press), Indiana (Feickert et al, 2019; Davis et al, in press), Kentucky (Feickert et al, 2019; Davis et al, in press), Louisiana (Sahota & Boyle, 2019), Maine (Collins et al, 2019; Simpson et al, 2019), Maryland (Davis et al, in press; Kropp et al, 2019), Michigan (Feickert et al, 2019; Kropp et al, 2019), Minnesota (Davis et al, in press), Nevada (Davis et al, in press), New Jersey (Feickert et al, 2019; Davis et al, in press), New Mexico (Sahota & Boyle, 2019), New York (Davis et al, in press), Ohio (Feickert et al, 2019), Oklahoma (Sahota & Boyle, 2019), Pennsylvania (Collins et al, 2019; Feickert et al, 2019), Utah (Kropp et al, 2019), Vermont (Davis et al, in press), Washington (Wang et al, 2018), West Virginia (Feickert et al, 2019; Hatcher, Vaddadi & Nafziger, 2019), and the US Territories (Cabera et al, 2018).…”

Section: Discussioncontrasting

confidence: 73%

Dynamic changes in prescription opioids from 2006 to 2017 in Texas

Ighodaro

McCall

Chung

et al. 2019

PeerJ

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Background The US is experiencing an epidemic of opioid overdoses which may be at least partially due to an over-reliance on opioid analgesics in the treatment of chronic non-cancer pain and subsequent escalation to heroin or illicit fentanyl. As Texas was reported to be among the lowest in the US for opioid use and misuse, further examination of this state is warranted. Materials and Methods This study was conducted to quantify prescription opioid use in Texas. Data was obtained from the publicly available US Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) which monitors controlled substances transactions from manufacture to commercial distribution. Data for 2006–2017 from Texas for ten prescription opioids including eight primarily used to relieve pain (codeine, fentanyl, hydrocodone, hydromorphone, meperidine, morphine, oxycodone, oxymorphone) and two (buprenorphine and methadone) for the treatment of an Opioid Use Disorder (OUD) were examined. Results The change in morphine mg equivalent (MME) of all opioids (+23.3%) was only slightly greater than the state’s population gains (21.1%). Opioids used to treat an OUD showed pronounced gains (+90.8%) which were four-fold faster than population growth. Analysis of individual agents revealed pronounced elevations in codeine (+387.5%), hydromorphone (+106.7%), and oxycodone (+43.6%) and a reduction in meperidine (−80.3%) in 2017 relative to 2006. Methadone in 2017 accounted for a greater portion (39.5%) of the total MME than hydrocodone, oxycodone, morphine, hydromorphone, oxymorphone, and meperidine, combined. There were differences between urban and rural areas in the changes in hydrocodone and buprenorphine. Conclusions Collectively, these findings indicate that continued vigilance is needed in Texas to appropriately treat pain and an OUD while minimizing the potential for prescription opioid diversion and misuse. Texas may lead the US in a return to pre-opioid epidemic prescription levels.

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“…ARCOS also reports on opioid distribution by the first-three digits of the zip-code (Supplemental Figure S1). ARCOS has been used in prior pharmacoepidemiological reports [3][4][5]8,23,30]. Nine opioid medications primarily used for pain: codeine, fentanyl, morphine, hydrocodone, hydromorphone, meperidine, oxycodone, oxymorphone, and tapentadol, and two primarily for opioid use disorder (OUD): methadone and buprenorphine, were obtained by quarter from 2007 to 2017 in Colorado, Utah, and Maryland.…”

Section: Methodsmentioning

confidence: 99%

Prescription Opioid Distribution after the Legalization of Recreational Marijuana in Colorado

Lopez

Nichols

Chung

et al. 2020

IJERPH

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There have been dynamic changes in prescription opioid use in the US but the state level policy factors contributing to these are incompletely understood. We examined the association between the legalization of recreational marijuana and prescription opioid distribution in Colorado. Utah and Maryland, two states that had not legalized recreational marijuana, were selected for comparison. Prescription data reported to the Drug Enforcement Administration for nine opioids used for pain (e.g., fentanyl, morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone) and two primarily for opioid use disorder (OUD, methadone and buprenorphine) from 2007 to 2017 were evaluated. Analysis of the interval pre (2007–2012) versus post (2013–2017) marijuana legalization revealed statistically significant decreases for Colorado (P < 0.05) and Maryland (P < 0.01), but not Utah, for pain medications. There was a larger reduction from 2012 to 2017 in Colorado (–31.5%) than the other states (–14.2% to –23.5%). Colorado had a significantly greater decrease in codeine and oxymorphone than the comparison states. The most prevalent opioids by morphine equivalents were oxycodone and methadone. Due to rapid and pronounced changes in prescription opioid distribution over the past decade, additional study with more states is needed to determine whether cannabis policy was associated with reductions in opioids used for chronic pain.

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Opioid Prescribing Laws Are Not Associated with Short-term Declines in Prescription Opioid Distribution

Cited by 47 publications

References 24 publications

Peer Review #1 of "Dynamic changes in prescription opioids from 2006 to 2017 in Texas (v0.1)"

Peer Review #1 of "Dynamic changes in prescription opioids from 2006 to 2017 in Texas (v0.1)"

Dynamic changes in prescription opioids from 2006 to 2017 in Texas

Prescription Opioid Distribution after the Legalization of Recreational Marijuana in Colorado

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