Health + Behavior

State laws aimed at curbing prescription opioid abuse have had little impact

Researchers from UCLA Law and Dartmouth analyze effect of laws on opioid use by disabled Medicare beneficiaries

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A new study by researchers from UCLA School of Law and the Dartmouth Institute of Health Policy and Clinical Practice found that state laws aimed at curbing prescription opioid abuse have had no measurable effect on opioid use by a vulnerable population with high rates of use.

Responding to a fourfold rise in death rates between 2006 and 2012, states collectively enacted 81 laws restricting prescribing and dispensing of prescription opioids. “States hoped passing a range of laws might help," said UCLA law professor Jill Horwitz. "So they are enacting small fixes — forbidding patients from 'doctor-shopping,' and requiring doctors to use tamper-resistant prescription forms. They are also implementing major efforts such as prescription drug-monitoring programs — online databases that allow law enforcement and clinicians to monitor prescriptions.”

The researchers analyzed the effects of these laws on prescription opioid use in a national population of 2.2 million disabled Medicare beneficiaries ages 21 to 64. Their analysis revealed no significant association between state laws and hazardous prescribing patterns, such as, very high daily opioid doses (equal to 120 mg or more of morphine) and the rate of nonfatal overdose. States introducing multiple laws — three or more from 2006-2012 — experienced lower growth in the population receiving opioids chronically, or from multiple prescribers, but the impact was small and not statistically significant.

“We studied a particularly vulnerable population, disabled Medicare beneficiaries. They have higher rates of opioid use, poverty and complex medical conditions compared to the general U.S. population,” said Dartmouth Institute professor Ellen Meara, the study’s lead author. “Because of their high rate of death from prescription opioid overdose, they could have benefited from effective regulation. (In 2008, death rates from prescription opioid overdose in the study sample were nearly 10 times the U.S. rate: 46.6 versus 4.8 per 100,000.)

“However, the laws appear weak and slow relative to the epidemic they aim to curb,” Meara said.

To read the entire story, go to the UCLA School of Law website.

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