The Influence of State Restrictions on Opioid Prescribing: 2006-2018.

Abstract

Objective: To measure the longitudinal effect of opioid restrictions on prescribing patterns at the state and regional levels.

Design: Health policy evaluation using a Poisson regression of opioid metrics from federal repositories to model what the estimated opioid counts are for the next fiscal year.

Setting: State-specific prescribed opioid counts between 2006 and 2018 from CDC reports; population data were obtained from the U.S. Census Bureau for 2006-2018; and opioid prescribing restrictions were extracted from published reports and state regulatory databases.

Intervention: Poisson regression models were fitted to assess the relationship of statewide restrictions on opioid prescribing counts adjusting for states' population.

Main outcome measure: Estimated opioid counts provided by the Poisson regression model.

Results: Per capita rates of prescribed opioids peaked in 2012 at 86.2 per 100 population. Prescribing restrictions are associated with statistically significant decreases in opioid prescribing. Controlling for population and year, we found for every 100 opioid prescriptions in a state without restrictions, only 98 opioid prescriptions are expected for every additional year in a state with restrictions in place.

Conclusions: Contrary to other research conducted over a shorter study period, we found that restrictions do reduce opioid prescribing; however, a statistically significant change in rates may not be detectable in the early years after restrictions are enacted.