Policy intended to curb opioid prescribing associated with increase in filled opioid prescriptions after surgery

Bottom Line: The U.S. Drug Enforcement Administration in 2014 moved to limit prescribing of pain medications containing the opioid hydrocodone from schedule III (a class of controlled substances) to the more restrictive schedule II. As a result, commonly prescribed formulations of hydrocodone were limited to a 90-day supply and could no longer be prescribed by telephone or fax. This analysis examined opioid prescriptions filled by about 22,000 privately insured patients who had common elective surgical procedures from 2012 to 2015 in Michigan. Researchers found that changing hydrocodone to the more restrictive schedule II was associated with an increase in the amount of opioids filled in the initial prescription after surgery. Most of the increase was accounted for by hydrocodone, which was the most commonly prescribed opioid following surgery. Date were drawn from a single state so the study observations may not be generalizable to other regions. Future efforts aimed at curbing opioid prescribing should include prescriber education and follow-up to make sure corresponding reductions in opioid prescribing result.

Authors: Jennifer Waljee, M.D., M.P.H., University of Michigan, Ann Arbor, and coauthors

To Learn More: The full study is available on the For The Media website.

Related material: The JAMA Surgery study, "Association of the Use of a Mandatory Prescription Drug Monitoring Program With Prescribing Practices for Patients Undergoing Elective Surgery," by Richard J. Barth Jr., M.D., Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, and coauthors is also available on the For The Media website.

(doi:10.1001/jamasurg.2018.2651)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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