State Opioid Laws Have Been Close to Useless for Disabled Adults

State opioid laws strive to reduce prescription painkiller use, but a new study found that they have no impact in a population with high usage rates.

State opioid laws strive to reduce prescription painkiller use, but a new study found that they have no impact in a population with high usage rates.

From 2006 to 2012, opioid-related deaths increased fourfold. As a result, 81 laws putting tighter reigns on prescribing were collectively put in place among the states. One of them requires physicians to prescribe tamper-resistant drugs and another doesn’t allow patients to go to multiple doctors for prescriptions. Another strategy was implementing online databases where clinicians and law enforcement can monitor prescriptions, called prescription drug monitoring programs (PDMPs) — online databases where clinicians and law enforcement can monitor prescriptions – were also implemented.

PDMPs are expensive, so if these databases are going to be in place, it’s important to know if they’re actually working or not. Unfortunately, researchers from The Dartmouth Institute of Health Policy and Clinical Practice and University of California, Los Angeles (UCLA) School of Law found that there has been no measurable effect, as described in The New England Journal of Medicine.

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The team made this determination by looking at data on 2.2 million disabled Medicare beneficiaries (ages 21 to 64), who have higher opioid use rates than the general population. The state laws and dangerous prescribing patterns, like a daily dosage of 120 mg or more of morphine, did not have a significant impact on the rate of nonfatal overdose.

“Because of their high rate of death from prescription opioid overdose, they could have benefited from effective regulation. However, the laws appear weak and slow relative to the epidemic they aim to curb,” lead author Ellen Meara, PhD, a professor at the Dartmouth Institute, said in a news release.

The states which enforced three or more laws from 2006 to 2012 had a lower amount of patients receive opioids chronically or from multiple doctors, however, the figures were not statistically significant.

Some laws have been strengthened since 2012. For one, prescribers in 20 states cannot give controlled substances to new patients without consulting the PDMP. The Dartmouth-UCLA team plans to look at the impact of these stricter laws.

“Successful prescription opioid regulation should stroke the hard balance between controlling misuse and fostering compassionate pain management,” said senior author Nancy Morden, MD, a primary care physician. “Clinicians need to carefully consider their role in prescription opioid misuse and overdose.”

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