Controlled substance laws are not associated with reductions in hazardous opioid use or overdose among disabled Medicare beneficiaries, according to research published in the New England Journal of Medicine.
Ellen Meara, PhD, Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, and colleagues, analyzed the associations between prescription-opioid receipt and state-level controlled-substance laws. Data were collected for disabled Medicare beneficiaries between the ages of 21 and 64 who were alive between 2006 and 2012 (8.7 million person-years). The researchers examined the annual prevalence of beneficiaries with 4 or more opioid prescribers, prescriptions yielding a daily morphine-equivalent dose (MED) greater than 120 mg, and treatment for nonfatal prescription opioid overdose, and estimated how opioid outcomes differed based on 8 types of state-level laws.
Between 2006 and 2012, states added 81 controlled substance laws. In 2012, 47% of Medicare beneficiaries filled opioid prescriptions, 8% had 4 or more opioid prescribers, 5% had a daily MED greater than 120 mg, and 0.3% were treated for nonfatal prescription opioid overdose.
“We observed no significant associations between opioid outcomes and specific types of laws or the number of types enacted,” concluded Dr Meara. “For example, the percentage of beneficiaries with a prescription yielding a daily MED of more than 120 mg did not decline after adoption of a prescription drug monitoring program.”
- Meara E, Horowitz JR, Powell W, et al. State legal restrictions and prescription opioid use among disabled adults. N Engl J Med. 2016; doi: 10.1056/NEJMsa1514387