The Effects of Kentucky's Comprehensive Opioid Legislation on Patients Presenting with Prescription Opioid or Heroin Abuse to One Urban Emergency Department

Patterns of opioid use during initial buprenorphine/naloxone treatment in relation to changes in opioid management laws in Kentucky

“…Victor et al had similar findings as our study where patients who were involved in a drug treatment program from 2010 to 2013, reported a decrease in illicit opioids with an increase in heroin use and that HB1 had an overall effect of reducing illicit opioid use . Faryar et al also described a decrease in non‐heroin opioid users with an increase in heroin users from 2009 to 2014, however, they noticed this trend prior to the passage of HB1, but noticed a similar trend as our study where non‐heroin opioid use continued to decline with a rise in heroin use. Several studies have referenced this notion of a transition from a non‐heroin opioid to heroin .…”

“…The purpose of this study was to determine the patterns of opioid use when presenting to an outpatient office for treatment with buprenorphine/naloxone (BUP/NAL) and its relation to 2012 HB1. Other studies conducted in KY witnessed a decline in non‐heroin opioids from 2009 to 2014 and an increase in heroin in patients treated in emergency departments . Victor et al observed a similar trend of declining non‐heroin opioid use and a rise in heroin in 14 federally regulated opioid treatment programs in years 2010–2013 .…”

“…The Commonwealth of Kentucky (KY) has been greatly impacted by the opioid epidemic and ranks within the top five states where accidental drug overdose surpasses the national average . After adjusting for age, in 2012, citizens in KY had a mortality rate of 25/100,000 for drug overdoses, as compared to the national mortality rate of 5.1/100,000 .…”

“…After adjusting for age, in 2012, citizens in KY had a mortality rate of 25/100,000 for drug overdoses, as compared to the national mortality rate of 5.1/100,000 . To address the opioid epidemic at a state level, KY passed legislation in 2012 House Bill 1 (HB1) that sought to curtail unnecessary scheduled analgesic prescriptions by placing mandatory regulations on prescribing and dispensing of prescription opioids . As a result, physicians have increased responsibilities when prescribing controlled substances and must use a prescription drug monitoring program (PDMP) called Kentucky All Schedule Prescription Electronic Reporting (KASPER) .…”

“…As a result, physicians have increased responsibilities when prescribing controlled substances and must use a prescription drug monitoring program (PDMP) called Kentucky All Schedule Prescription Electronic Reporting (KASPER) . This system tracks the use, prescription, and dispensing of all controlled medications in KY and all physicians must register for KASPER and utilize it prior to prescribing a controlled medication . Non‐compliance with the 2012 HB1 regulations can result in legal charges and may jeopardize the clinician's ability to continue practicing medicine in KY .…”