Two Florida laws, enacted to combat prescription drug abuse and misuse in that state, led to a small but significant decrease in the amount of opioids prescribed the first year the laws were in place, a new study by Johns Hopkins Bloomberg School of Public Health researchers suggests.
One measure created a Prescription Drug Monitoring Program, a database that tracks individual prescriptions, including patient names, dates and amounts prescribed, so physicians can be on the lookout for excesses associated with addiction and illicit use. Another addresses so-called "pill mills," loosely regulated pain clinics that often see disproportionately high levels of opioid prescriptions. Florida's "pill mill" measure requires clinics to register with the state and be owned by a physician.
In the first 12 months after implementation of these laws, Florida's opioid prescriptions fell slightly, slipping 1.4 percent. At the same time, the volume of opioids prescribed decreased 2.5 percent, compared with Georgia's, a decrease equivalent to 750,000 pills per month. The amount per prescription also declined 5.6 percent, also compared with Georgia's, the researchers found. The declines were among the heaviest users and prescribers.
The findings will be published online August 17 in JAMA Internal Medicine.
In the years leading up to enactment, Florida, like the rest of the country, experienced a jump in prescription-drug overdose deaths. In Florida, they increased more than 80% between 2003 and 2009. The U.S. Centers for Disease Control and Prevention estimates that 44 people die each day from a prescription-drug overdose.
"These findings support the notion that there are policy solutions to the prescription drug epidemic," says Lainie Rutkow, JD, MPH, PhD, an associate professor in the Department of Health Policy and Management at the Bloomberg School of Public Health.
The two measures are considered important policy tools in the fight against opioid abuse and misuse. All fifty states and the District of Columbia currently have drug-monitoring programs in place. At least a dozen states have started regulating pain-management clinics.
For their analysis, researchers compared opioid prescriptions in Florida with those in Georgia for the 12 months before and after the two policies were implemented in the summer of 2011: July 2010 through June 2011 and October 2011 through September 2012. At the time, Georgia did not have comparable programs in place. The prescription data came from IMS Health LifeLink LRx, and included 36.9 million opioid prescriptions in Florida and Georgia.
The study examined total opioid volume prescribed per month; the average dosage, or morphine milligram equivalent, per transaction; the average days supply per transaction; and the total number of prescriptions. The study found no effect on the number of days supply.
"Effects of Florida's Prescription Drug Monitoring Program and Pill Mill Law on Opioid Prescribing and Utilization" was written by Lainie Rutkow, JD, PhD, MPH; Hsien-Yen Chang, PhD; Matthew Daubresse,
MHS; Daniel W. Webster, ScD, MPH; Elizabeth A. Stuart, PhD; Caleb Alexander, MD, MS.
The study was funded by the Robert Wood Johnson Foundation Public Health Law Research program and the U.S. Centers for Disease Control and Prevention.