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Prescription opioid policies and associations with opioid overdose and related adverse effects.
Harder, Valerie S; Varni, Susan E; Murray, Kimberly A; Plante, Timothy B; Villanti, Andrea C; Wolfson, Daniel L; Maruti, Sanchit; Fairfield, Kathleen M.
Afiliación
  • Harder VS; University of Vermont, Larner College of Medicine, Department of Pediatrics, 1 South Prospect Street, Burlington VT, 05401, USA; University of Vermont, Larner College of Medicine, Department of Surgery, 111 Colchester Avenue, Burlington, VT 05401, USA. Electronic address: Valerie.Harder@uvm.edu.
  • Varni SE; University of Vermont, Larner College of Medicine, Department of Pediatrics, 1 South Prospect Street, Burlington VT, 05401, USA.
  • Murray KA; Maine Medical Center Research Institute, Center for Outcomes Research and Evaluation, 509 Forest Avenue, Suite 200, Portland, Maine 04101, USA.
  • Plante TB; University of Vermont, Larner College of Medicine, Department of Medicine, 89 Beaumont Ave, Burlington, VT 05405, USA.
  • Villanti AC; University of Vermont, Larner College of Medicine, Department of Psychiatry, 1 South Prospect Street, Burlington VT, 05401, USA.
  • Wolfson DL; University of Vermont, Larner College of Medicine, Department of Surgery, 111 Colchester Avenue, Burlington, VT 05401, USA.
  • Maruti S; University of Vermont, Larner College of Medicine, Department of Psychiatry, 1 South Prospect Street, Burlington VT, 05401, USA.
  • Fairfield KM; Maine Medical Center, Department of Medicine, 22 Bramhall Street, Portland, Maine 04102, USA.
Int J Drug Policy ; 97: 103306, 2021 11.
Article en En | MEDLINE | ID: mdl-34107447
BACKGROUND: United States (US) policies to mitigate the opioid epidemic focus on reducing access to prescription opioids to prevent overdoses. We examined the impact of state policies in Vermont (July 2017) and Maine (July 2016) on opioid overdoses and opioid-related adverse effects. METHODS: Study population included patients 15 years and older in all-payer claims of Vermont (N = 597,683; Jan.2016-Dec.2018) and Maine (N = 1,370,960; Oct.2015-Dec.2017). We used interrupted time series analyses to assess the impact of opioid prescribing policies on monthly opioid overdose rate and opioid-related adverse effects rate. We used the International Classification of Disease-10-CM to identify overdoses (T40.0 × 1-T40.4 × 4, T40.601-T40.604, T40.691-T40.694) and adverse effects (T40.0 × 5, T40.2 × 5-T40.4 × 5, T40.605, T40.695). RESULTS: Immediately after the policy, the level of Vermont's opioid overdose rate increased by 34% (95% confidence interval, CI: 1.09, 1.65) while the level of opioid-related adverse effects rate decreased by 29% (95% CI: 0.58, 0.87). In Maine, there was no level change in opioid overdose rate, but the slope of the adverse effects rate after the policy decreased by 3.5% (95% CI: 0.94, 0.99). These results varied within age and rurality subgroups in both states. CONCLUSION: While the decrease in rate of adverse effects following the policy changes is promising, the increase in Vermont's opioid overdose rate may suggest there is an association between policy implementation and short-term risk to public health.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sobredosis de Opiáceos / Analgésicos Opioides Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Int J Drug Policy Asunto de la revista: SAUDE PUBLICA / TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2021 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sobredosis de Opiáceos / Analgésicos Opioides Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Int J Drug Policy Asunto de la revista: SAUDE PUBLICA / TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2021 Tipo del documento: Article Pais de publicación: Países Bajos