Advertisement

Effect of State Policy Changes in Florida on Opioid-Related Overdoses

  • Gery P. Guy Jr.
    Correspondence
    Address correspondence to: Gery P. Guy, Jr., PhD, MPH, Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway MSS106-8, Atlanta GA 30341.
    Affiliations
    Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
    Search for articles by this author
  • Kun Zhang
    Affiliations
    Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
    Search for articles by this author
Published:January 30, 2020DOI:https://doi.org/10.1016/j.amepre.2019.11.008

      Introduction

      With a rapid increase in prescription opioid overdose deaths and a proliferation of pain clinics in the mid-2000s, Florida emerged as an epicenter of the opioid overdose epidemic. In response, Florida implemented pain clinic laws and operationalized its Prescription Drug Monitoring Program. This study examines the effect of these policies on rates of inpatient stays and emergency department visits for opioid-related overdoses.

      Methods

      Using data from the 2008–2015 State Emergency Department Databases and State Inpatient Databases, quarterly rates of inpatient stays and emergency department visits for prescription opioid-related overdoses and heroin-related overdoses were computed. A comparative interrupted time series analysis examined the effect of these policies on opioid overdose rates. North Carolina served as a control state because it did not implement similar policies during the study period. The data were analyzed in 2019.

      Results

      Compared with North Carolina, Florida's polices were associated with reductions in the rates of prescription opioid-related overdose inpatient stays and emergency department visits, a level reduction of 2.31 per 100,000 and a reduction in the trend of 0.16 per 100,000 population each quarter. The policies were associated with a reduction of 13,532 inpatient stays and emergency department visits for prescription opioid-related overdoses during the study period. No statistically significant association was found between the policies and heroin-related overdose inpatient stays and emergency department visits.

      Conclusions

      To address the opioid overdose epidemic, states have implemented policies such as Prescription Drug Monitoring Programs and pain clinic laws designed to reduce inappropriate opioid prescribing. Such laws may be effective in reducing prescription opioid-related overdoses.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Dowell D
        • Haegerich TM
        • Chou R
        CDC guideline for prescribing opioids for chronic pain—United States, 2016.
        MMWR Recomm Rep. 2016; 65: 1-49
      1. CDC WONDER.
        CDC, National Center for Health Statistics, Atlanta, GA2017
        http://wonder.cdc.gov
        Date accessed: February 20, 2019
        • CDC
        Drug overdose deaths—Florida, 2003–2009.
        MMWR Morb Mortal Wkly Rep. 2011; 60: 869-872
        • Johnson H
        • Paulozzi L
        • Porucznik C
        • Mack K
        • Herter B
        Decline in drug overdose deaths after state policy changes – Florida, 2010-2012.
        MMWR Morb Mortal Wkly Rep. 2014; 63: 569-574
      2. Prescription drug monitoring program. Florida Statute §893.055 (2019).www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0800-0899/0893/Sections/0893.055.html. Accessed November 18, 2019.

        • Fink DS
        • Schleimer JP
        • Sarvet A
        et al. Association between prescription drug monitoring programs and nonfatal and fatal drug overdoses: a systematic review.
        Ann Intern Med. 2018; 168: 783-790
        • Dowell D
        • Zhang K
        • Noonan RK
        • Hockenberry JM
        Mandatory provider review and pain clinic laws reduce the amounts of opioids prescribed and overdose death rates.
        Health Aff (Millwood). 2016; 35: 1876-1883
        • Kennedy-Hendricks A
        • Richey M
        • McGinty EE
        • Stuart EA
        • Barry CL
        • Webster DW
        Opioid overdose deaths and Florida's crackdown on pill mills.
        Am J Public Health. 2016; 106: 291-297
        • Huecker MR
        • Shoff HW
        The law of unintended consequences: illicit for licit narcotic substitution.
        West J Emerg Med. 2014; 15: 561-563
        • Green CA
        • Perrin NA
        • Janoff SL
        • Campbell CI
        • Chilcoat HD
        • Coplan PM
        Assessing the accuracy of opioid overdose and poisoning codes in diagnostic information from electronic health records, claims data, and death records.
        Pharmacoepidemiol Drug Saf. 2017; 26: 509-517
        • Haffajee RL
        • Mello MM
        • Zhang F
        • Zaslavsky AM
        • Larochelle MR
        • Wharam JF
        Four states with robust prescription drug monitoring programs reduced opioid dosages.
        Health Aff (Millwood). 2018; 37: 964-974
        • Strickler GK
        • Zhang K
        • Halpin JF
        • Bohnert ASB
        • Baldwin GT
        • Kreiner PW
        Effects of mandatory prescription drug monitoring program (PDMP) use laws on prescriber registration and use and on risky prescribing.
        Drug Alcohol Depend. 2019; 199: 1-9
        • Wen H
        • Hockenberry JM
        • Jeng PJ
        • Bao Y
        Prescription Drug Monitoring Program Mandates: impact on opioid prescribing and related hospital use.
        Health Aff (Millwood). 2019; 38: 1550-1556
        • Paulozzi LJ
        • Kilbourne EM
        • Desai HA
        Prescription drug monitoring programs and death rates from drug overdose.
        Pain Med. 2011; 12: 747-754