The 2017 North Carolina STOP Act is Associated With an Accelerated Decrease in Opioid Dispensing: A Statewide Analysis, 2013-2019.

Background: This study aimed to: 1) quantify the dispensing and days' supply of opioid prescriptions prior to and after the NC STOP Act went into effect among Medicare Part D beneficiaries; 2) evaluate how the STOP Act impacted physician assistant and nurse practitioner opioid prescribing; and 3) evaluate whether the NC STOP Act is associated with reductions in opioid prescriptions' days' supply among Medicare Part D beneficiaries.

Methods: This was a secondary analysis of Medicare Part D Public Use Files for 2013-2019. Only North Carolina providers and select Schedule II (CII) and III (CIII) drugs and tramadol (CV) were included in the analysis. Multivariable Poisson regression models were used to analyze the data.

Results: In 2013, there were population-adjusted 180,565.2/100,000 claims for the included CII and CIII opioids, which decreased to 79,329.12/100,000 claims in 2019. Each of the multivariable Poisson regression models indicates a reduction in per-provider populationadjusted claims and days' supply after the NC STOP Act went into effect for both selected CII and CIII medications and for tramadol. The results also indicate that the number of prescriptions for CII, CIII, and tramadol decreased over time.

Limitations: Due to the nature of the observational study design, we cannot conclude that the 2017 legislation had an effect on populationadjusted claims for certain CII and CIII opioids.

Conclusions: Since 2013 there has been a decreasing trend in certain CII and CIII opioids dispensations in Medicare beneficiaries, and the trend accelerated after the STOP Act went into effect.