ArticleAmerican journal of preventive medicine2021
State Medical Board Policy and Opioid Prescribing: A Controlled Interrupted Time Series.
Article in American journal of preventive medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 19 citations in OpenAlex.
- Association between rapid opioid reduction or discontinuation and self-harm, suicide attempt, and suicide death among patients receiving high-dose, long-term opioid therapy in North Carolina, 2006-2018.American journal of epidemiology · 2025Article
- Impact of State Policies on Opioid Prescribing Among Surgery and Injury Patients: Controlled Interrupted Time-Series Study, North Carolina, 2014-2019.Pharmacoepidemiology and drug safety · 2025Article
- Sociogeographic determinants of rapid opioid reduction or discontinuation among patients on high-dose long-term opioid therapy in North Carolina, 2006-2018.Pain medicine (Malden, Mass.) · 2025Article
- Distribution of opioid analgesics by community racial/ethnic and socioeconomic profiles, 2011-2021.Pain · 2025Article
- Medicaid Expansion and Mortality Among Persons Who Were Formerly Incarcerated.JAMA network open · 2024Article
- Immigration Policy and the Health of Latina Mothers and Their Infants.Journal of immigrant and minority health · 2023Article
- Association of a State Prescribing Limits Policy with Opioid Prescribing and Long-term Use: an Interrupted Time Series Analysis.Journal of general internal medicine · 2023Article
- Intended and unintended consequences: Changes in opioid prescribing practices for postsurgical, acute, and chronic pain indications following two policies in North Carolina, 2012-2018 - Controlled and single-series interrupted time series analyses.Drug and alcohol dependence · 2023Article
- Association of Opioid Dose Reduction With Opioid Overdose and Opioid Use Disorder Among Patients Receiving High-Dose, Long-term Opioid Therapy in North Carolina.JAMA network open · 2022Article
- "The DEA would come in and destroy you": a qualitative study of fear and unintended consequences among opioid prescribers in WV.Substance abuse treatment, prevention, and policy · 2022Article
- Association Between Statewide Opioid Prescribing Interventions and Opioid Prescribing Patterns in North Carolina, 2006-2018.Pain medicine (Malden, Mass.) · 2021Article
- Implementation of mandatory opioid prescribing limits in North Carolina: healthcare administrator and prescriber perspectives.BMC health services research · 2021Article
- Reduction of Long-Term Opioid Prescribing for Back Pain in Community Health Centers After a Medicaid Policy Change.Journal of the American Board of Family Medicine : JABFMArticle
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
introductionIn March 2016, the Centers for Disease Control and Prevention issued opioid prescribing guidelines for chronic noncancer pain. In response, in April 2016, the North Carolina Medical Board launched the Safe Opioid Prescribing Initiative, an investigative program intended to limit the overprescribing of opioids. This study focuses on the association of the Safe Opioid Prescribing Initiative with immediate and sustained changes in opioid prescribing among all patients who received opioid and opioid discontinuation and tapering among patients who received high-dose (>90 milligrams of morphine equivalents), long-term (>90 days) opioid therapy.
methodsControlled and single interrupted time series analysis of opioid prescribing outcomes before and after the implementation of Safe Opioid Prescribing Initiative was conducted using deidentified data from the North Carolina Controlled Substances Reporting System from January 2010 through March 2017. Analysis was conducted in 2019-2020.
resultsIn an average study month, 513,717 patients, including patients who received 47,842 high-dose, long-term opioid therapy, received 660,912 opioid prescriptions at 1.3 prescriptions per patient. There was a 0.52% absolute decline (95% CI= -0.87, -0.19) in patients receiving opioid prescriptions in the month after Safe Opioid Prescribing Initiative implementation. Abrupt discontinuation, rapid tapering, and gradual tapering of opioids among patients who received high-dose, long-term opioid therapy increased by 1% (95% CI= -0.22, 2.23), 2.2% (95% CI=0.91, 3.47), and 1.3% (95% CI=0.96, 1.57), respectively, in the month after Safe Opioid Prescribing Initiative implementation.
conclusionsAlthough Safe Opioid Prescribing Initiative implementation was associated with an immediate decline in overall opioid prescribing, it was also associated with an unintended immediate increase in discontinuations and rapid tapering among patients who received high-dose, long-term opioid therapy. Better policy communication and prescriber education regarding opioid tapering best practices may help mitigate unintended consequences of statewide policies.
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