ReviewDrug and alcohol dependence2014
What we know, and don't know, about the impact of state policy and systems-level interventions on prescription drug overdose.
Review in Drug and alcohol dependence, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
120 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Evidence for state, community and systems-level prevention strategies to address the opioid crisis.Drug and alcohol dependence · 2019Pooled it
- Guideline
- A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018.Public health reports (Washington, D.C. : 1974)Pooled it
- Improving Adherence to Long-term Opioid Therapy Guidelines to Reduce Opioid Misuse in Primary Care: A Cluster-Randomized Clinical Trial.JAMA internal medicine · 2017Trial
- A pilot randomized clinical trial of an intervention to reduce overdose risk behaviors among emergency department patients at risk for prescription opioid overdose.Drug and alcohol dependence · 2016Trial
- Proof of Concept of Large Language Models for Opioid Treatment Policy Surveillance: 97% Agreement With Subject Matter Experts.Journal of studies on alcohol and drugs · 2026Article
- Distribution of opioid analgesics by community racial/ethnic and socioeconomic profiles, 2011-2021.Pain · 2025Article
- An evidence-based digital prescription opioid safety toolkit for national dissemination: co-design and user testing.Frontiers in digital health · 2025Article
- Declining but Pronounced State-Level Disparities in Prescription Opioid Distribution in the United States.Pharmacy (Basel, Switzerland) · 2024Article
- Association between prescription drug monitoring programs use mandates and prescription stimulants received by Medicaid enrollees.Drug and alcohol review · 2023Article
- Adult Medical Cannabinoid Use and Changes in Prescription Controlled Substance Use.Cannabis and cannabinoid research · 2023Article
- Prescription drug monitoring programs use mandates and prescription stimulant and depressant quantities.BMC public health · 2023Article
- Systematic Identification and Categorization of Opioid Prescribing and Dispensing Policies in 16 States and Washington, DC.Pain medicine (Malden, Mass.) · 2023Article
- Understanding the Dynamics of More Restrictive Medicines Policy: A Case Study of Codeine Up-Scheduling in Australia.International journal of health policy and management · 2023Article
- U.S. state policies on opioid prescribing during the peak of the prescription opioid crisis: Associations with opioid overdose mortality.The International journal on drug policy · 2022Article
- Trends in Opioid Prescribing by General Dentists and Dental Specialists in the U.S., 2012-2019.American journal of preventive medicine · 2022Article
- Leveraging the Prescription Drug Monitoring Program to Curb Opioid Prescribing in Arkansas.Journal of prevention (2022) · 2022Article
- Pediatric drug overdose mortality: contextual and policy effects for children under 12 years.Pediatric research · 2021Article
- Prescription Opioid Laws and Opioid Dispensing in US Counties: Identifying Salient Law Provisions With Machine Learning.Epidemiology (Cambridge, Mass.) · 2021Article
- Predictors of Safe Prescription Opioid Storage and Participation in Drug Take-Back Events: Results from a Statewide Survey.Journal of community health · 2021Article
60 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundDrug overdose deaths have been rising since the early 1990s and is the leading cause of injury death in the United States. Overdose from prescription opioids constitutes a large proportion of this burden. State policy and systems-level interventions have the potential to impact prescription drug misuse and overdose.
methodsWe searched the literature to identify evaluations of state policy or systems-level interventions using non-comparative, cross-sectional, before-after, time series, cohort, or comparison group designs or randomized/non-randomized trials. Eligible studies examined intervention effects on provider behavior, patient behavior, and health outcomes.
resultsOverall study quality is low, with a limited number of time-series or experimental designs. Knowledge and prescribing practices were measured more often than health outcomes (e.g., overdoses). Limitations include lack of baseline data and comparison groups, inadequate statistical testing, small sample sizes, self-reported outcomes, and short-term follow-up. Strategies that reduce inappropriate prescribing and use of multiple providers and focus on overdose response, such as prescription drug monitoring programs, insurer strategies, pain clinic legislation, clinical guidelines, and naloxone distribution programs, are promising. Evidence of improved health outcomes, particularly from safe storage and disposal strategies and patient education, is weak.
conclusionsWhile important efforts are underway to affect prescriber and patient behavior, data on state policy and systems-level interventions are limited and inconsistent. Improving the evidence base is a critical need so states, regulatory agencies, and organizations can make informed choices about policies and practices that will improve prescribing and use, while protecting patient health.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.