2009-2021 年美国处方药监控计划整合和强制使用政策对美沙酮和丁丙诺啡治疗阿片类药物使用障碍的分布的影响。

IF 3.9 2区 医学 Q1 PSYCHIATRY Drug and alcohol dependence Pub Date : 2024-08-29 DOI:10.1016/j.drugalcdep.2024.112432
Christian E. Johnson , George L. Wehby , Elizabeth A. Chrischilles , Stephan Arndt , Ryan M. Carnahan
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引用次数: 0

摘要

背景:处方药监控项目(PDMPs)已被证明可以减少阿片类药物的疼痛处方,但 PDMPs 是否会影响阿片类药物使用障碍的用药情况,目前尚不十分清楚。PDMP 整合和强制使用政策是各州为提高处方者使用 PDMP 而实施的两种方法。本研究考察了 2009 年至 2021 年期间这两种方法对 50 个州和华盛顿特区美沙酮和丁丙诺啡分配的影响:方法:使用 Callaway 和 Sant'Anna 差异模型估算了 PDMP 整合和强制使用政策对四种结果(丁丙诺啡在阿片类药物治疗项目中的分配情况、丁丙诺啡在药店中的分配情况、美沙酮在阿片类药物治疗项目中的分配情况以及美沙酮和丁丙诺啡的总和分配情况)的影响,并对同时出现的阿片类药物相关州政策进行了控制:结果:在实施强制使用政策后,药店的丁丙诺啡销售量下降了 8%(95 % CI -14 %,-1 %)。美沙酮在阿片类药物治疗项目中的销售量增加了 17%(95% CI 4%,34%),美沙酮和丁丙诺啡的总销售量在这两种方法共同实施后增加了 6%(95% CI -0%,14%):结论:自 2009 年以来,美沙酮和丁丙诺啡的分发量有所增加,但目前只有不到四分之一的阿片类药物使用障碍患者接受了这些药物治疗。我们观察到,整合 PDMP 和强制使用政策对美沙酮和丁丙诺啡的分配产生了微小的净效益。政策制定者应继续评估 PDMP 对阿片类药物使用障碍患者获得药物治疗的影响,并考虑采取其他方法来增加治疗机会。
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Examining the effect of prescription drug monitoring program integration and mandatory use policies on the distribution of methadone and buprenorphine for opioid use disorder, United States, 2009–2021

Background

Prescription drug monitoring programs (PDMPs) have been shown to reduce opioid prescribing for pain, but it is not well understood whether PDMPs influence utilization of medications for opioid use disorder. PDMP integration and mandatory use policies are two approaches implemented by states to increase use of PDMPs by prescribers. This study examined the effect of these approaches on distribution of methadone and buprenorphine from 2009 to 2021 for 50 states and DC.

Methods

The effect of PDMP integration and mandatory use policies on four outcomes (distribution of buprenorphine to opioid treatment programs, distribution of buprenorphine to pharmacies, distribution of methadone to opioid treatment programs, and the total combined distribution of methadone and buprenorphine) was estimated using a Callaway and Sant’Anna difference-in-differences model, controlling for co-occurring opioid-related state policies.

Results

Distribution of buprenorphine to pharmacies decreased 8 % (95 % CI −14 %, −1 %) following implementation of mandatory use policies. Distribution of methadone to opioid treatment programs increased 17 % (95 % CI 4 %, 34 %) and the total combined distribution of methadone and buprenorphine increased 6 % (95 % CI −0 %, 14 %) following the joint implementation of both approaches.

Conclusion

Distribution of methadone and buprenorphine has increased since 2009, but less than a quarter of people with opioid use disorder currently receive these medications. We observed a small net benefit of PDMP integration and mandatory use policies on distribution of methadone and buprenorphine. Policymakers should continue to assess the impact of PDMPs on access to medications for opioid use disorder and consider additional approaches to increase access to treatment.

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来源期刊
Drug and alcohol dependence
Drug and alcohol dependence 医学-精神病学
CiteScore
7.40
自引率
7.10%
发文量
409
审稿时长
41 days
期刊介绍: Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.
期刊最新文献
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