Evidence map›Paper›PMID 32101973›Full record

ArticleAnesthesiology2020

Drug Enforcement Agency 2014 Hydrocodone Rescheduling Rule and Opioid Dispensing after Surgery.

Mark D Neuman, Sean Hennessy, Dylan S Small, Craig Newcomb, Lakisha Gaskins, Colleen M Brensinger, Duminda N Wijeysundera, Brian T Bateman, Hannah Wunsch

Open access · bronzeAbstract read
In one paragraph

Article in Anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 35% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Mark D NeumanFrom the Department of Anesthesiology and Critical Care (M.D.N., L.G.) Center for Perioperative Outcomes Research and Transformation (M.D.N., L.G.) Center for Pharmacoepidemiology Research and Training (M.D.N., S.H., D.S.S.) Department of Biostatistics, Epidemiology, and Informatics (S.H.) Center for Clinical Epidemiology and Biostatistics (S.H., D.S.S.,C.N., C.M.B.), Perelman School of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania (M.D.N., S.H., D.S.S.) Department of Statistics, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania (D.S.S.) Department of Anesthesia, St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada (D.N.W.) Department of Anesthesia, Perioperative, and Pain Medicine and Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (B.T.B.) Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (H.W.) Department of Anesthesia and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada (H.W.).
Sean Hennessy
Dylan S Small
Craig Newcomb
Lakisha Gaskins
Colleen M Brensinger
Duminda N Wijeysundera
Brian T Bateman
Hannah Wunsch
Center for Clinical Research (United States) · US

Funding

Acute Pain Management and Long-term Opioid Use after SurgeryR01DA042299 · NIDA · SUNNYBROOK RESEARCH INSTITUTE · PI NEUMAN, MARK DAVID, WUNSCH, HANNAH · 2017 to 2020
$2.0M
NIDA NIH HHS R01 DA042299
6 · The paper itself

Abstract

backgroundIn 2014, the U.S. Drug Enforcement Agency reclassified hydrocodone from Schedule III to Schedule II of the Controlled Substances Act, resulting in new restrictions on refills. The authors hypothesized that hydrocodone rescheduling led to decreases in total opioid dispensing within 30 days of surgery and reduced new long-term opioid dispensing among surgical patients.

methodsThe authors studied privately insured, opioid-naïve adults undergoing 10 general or orthopedic surgeries between 2011 and 2015. The authors conducted a differences-in-differences analysis that compared overall opioid dispensing before versus after the rescheduling rule for patients treated by surgeons who frequently prescribed hydrocodone before rescheduling (i.e., patients who were functionally exposed to rescheduling's impact) while adjusting for secular trends via a comparison group of patients treated by surgeons who rarely prescribed hydrocodone (i.e., unexposed patients). The primary outcome was any filled opioid prescription between 90 and 180 days after surgery; secondary outcomes included the 30-day refill rate and the amount of opioids dispensed initially and at 30 days postoperatively.

resultsThe sample included 65,136 patients. The percentage of patients filling a prescription beyond 90 days was similar after versus before rescheduling (absolute risk difference, -1.1%; 95% CI, -2.3% to 0.1%; P = 0.084). The authors estimated the rescheduling rule to be associated with a 45.4-mg oral morphine equivalent increase (difference-in-differences estimate; 95% CI, 34.2-56.7 mg; P < 0.001) in initial opioid dispensing, a 4.1% absolute decrease (95% CI, -5.5% to -2.7%; P < 0.001) in refills within 30 days, and a 37.7-mg oral morphine equivalent increase (95% CI, 20.6-54.8 mg; P = 0.008) in opioids dispensed within 30 days.

conclusionsAmong patients treated by surgeons who frequently prescribed hydrocodone before the Drug Enforcement Agency 2014 hydrocodone rescheduling rule, rescheduling did not impact long-term opioid receipt, although it was associated with an increase in opioid dispensing within 30 days of surgery.

Indexed as

Controlled SubstancesDrug PrescriptionsAdultAnalgesics, OpioidDrug and Narcotic ControlFemaleHumansHydrocodoneInsurance Claim ReviewMaleMiddle AgedPostoperative PainRetrospective StudiesUnited StatesAnalgesics, OpioidControlled SubstancesHydrocodone

Identifiers

PMID32101973
PMCPMC7160003
OpenAlexW3006838978

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.