State limits on initial opioid prescription duration may influence prescribing

(HealthDay)—State laws restricting the duration of initial opioid prescriptions are associated with changes in opioid prescribing, according to a research letter published online Aug. 9 in JAMA Internal Medicine.

John D. Cramer, M.D., from Wayne State University in Detroit, and colleagues assessed the effect of legislation implemented in 23 states (March 2016 to July 2018) to limit the duration of initial opioid prescriptions to a maximum of seven days (17 states: no more than seven days; two states: no more than five days; four states: no more than three days). The Medicare Part D Prescriber Public Use File (2013 through 2018) was used to identify opioid prescriptions.

The researchers found that the mean number of days of opioid prescribed per enrollee decreased by a mean of 11.6 days in states with duration limits versus a mean decline of 10.1 days in control states. Days of opioid prescribed were similar in states with and without restrictions before limits were implemented in 2016. State laws limiting opioid prescriptions to no more than seven days were associated with a reduction in opioid prescribing by 1.7 days per enrollee in an adjusted analysis. The largest decreases in opioid prescribing were seen among primary care physicians, although this finding was not significantly different in states exposed to the policy versus control states. However, there were significant reductions in opioid prescribing among surgeons and dentists, pain specialists, and other specialists in states with laws limiting duration.

"The decline in opioid prescribing occurred in states exposed to the policy and in control states, suggesting either that state laws influenced prescribing behavior across state lines or that this legislation is just one of many interventions that have helped to reduce opioid prescribing," the authors write.