Evidence map›Paper›PMID 34107447›Full record

ArticleThe International journal on drug policy2021

Prescription opioid policies and associations with opioid overdose and related adverse effects.

Valerie S Harder, Susan E Varni, Kimberly A Murray, Timothy B Plante, Andrea C Villanti, Daniel L Wolfson, Sanchit Maruti, Kathleen M Fairfield

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 21% 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

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
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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

8 authors at 3 institutions in 1 country.

Valerie S HarderUniversity 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.
Susan E VarniUniversity of Vermont, Larner College of Medicine, Department of Pediatrics, 1 South Prospect Street, Burlington VT, 05401, USA.
Kimberly A MurrayMaine Medical Center Research Institute, Center for Outcomes Research and Evaluation, 509 Forest Avenue, Suite 200, Portland, Maine 04101, USA.
Timothy B PlanteUniversity of Vermont, Larner College of Medicine, Department of Medicine, 89 Beaumont Ave, Burlington, VT 05405, USA.
Andrea C VillantiUniversity of Vermont, Larner College of Medicine, Department of Psychiatry, 1 South Prospect Street, Burlington VT, 05401, USA.
Daniel L WolfsonUniversity of Vermont, Larner College of Medicine, Department of Surgery, 111 Colchester Avenue, Burlington, VT 05401, USA.
Sanchit MarutiUniversity of Vermont, Larner College of Medicine, Department of Psychiatry, 1 South Prospect Street, Burlington VT, 05401, USA.
Kathleen M FairfieldMaine Medical Center, Department of Medicine, 22 Bramhall Street, Portland, Maine 04102, USA.
University of Vermont · USMaine Medical Center · USMaine Medical Center · US

Funding

Understanding Factors Influencing COVID-19 Testing and Vaccination in Immigrant Low-income and Homeless Populations and Testing Targeted InterventionsU54GM115516 · NIGMS · MAINEHEALTH · PI CLIFFORD JAMES ROSEN · 2017 to 2026
$51.6M
Vermont Center on Behavior and HealthP20GM103644 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI SIGMON, STACEY C · 2013 to 2022
$21.3M
NIGMS NIH HHS P20 GM103644NIGMS NIH HHS U54 GM115516
6 · The paper itself

Abstract

backgroundUnited 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.

methodsStudy 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).

resultsImmediately 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.

conclusionWhile 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.

Indexed as

Analgesics, OpioidOpiate OverdoseHumansPolicyPractice Patterns, Physicians'PrescriptionsUnited StatesAnalgesics, OpioidAll-payer claimsInterrupted time seriesMulti-stateOpioidsPrescription policy

Identifiers

PMID34107447
PMCPMC8585674
OpenAlexW3171461065

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.