State-Level Opioid Policy Effects of Opioid Prescribing, Use and Overdose
Although a growing literature finds that certain opioid-related policies—including prescription drug monitoring programs (PDMPs) and pain clinic laws—are associated with reductions in opioid prescribing and even prescription opioid-related overdose deaths, much is still unknown about the effects of these policies. This secondary data analysis study funded as a KL2 project aims to use de-identified medical claims and publicly available data on overdose deaths, state and other relevant laws, and treatment locations to probe these gaps in the literature. Specific research aims of this project include to do the following: (1) assess differential trends in opioid prescribing/dispensing and overdose by patient characteristics (age, sex, race/ethnicity) and physician specialty, all relative to prevalent state-level opioid policies; and (2) examine differential trends in high-risk opioid prescribing/dispensing, such as polypharmacy and doctor shopping, relative to prevalent state-level opioid policies. Opioid policies of focus will include those that have the potential or have been demonstrated to be of high impact, including without limitation robust PDMPs, pain clinic laws, prescribing guidelines, naloxone access facilitators, and insurer/pharmacy benefit manager prescription review and limitation policies. We will examine changes in prescribing across multiple relevant specialties, including surgery, anesthesiology, primary care, and emergency department providers.