ArticleDrug and alcohol dependence2023
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.
Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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
16 citing papers in PubMed, 16 citations in OpenAlex.
- Decreased Gabapentin Prescription Fills Among Medicaid Enrollees Following State-Level Schedule V Controlled Substance Classification in Kentucky and West Virginia.Substance use & addiction journal · 2026Article
- Transitions from first drug use to illicit opioid and injection drug use in a multisite rural U.S. cohort of people who use drugs.Harm reduction journal · 2026Article
- Opioid dose, duration, and risk of use disorder in Medicaid patients with musculoskeletal pain.Pain medicine (Malden, Mass.) · 2026Article
- The impact of opioid prescribing guidelines on opioid dispensation: A systematic review and meta-analysis.Canadian journal of pain = Revue canadienne de la douleur · 2026Review
- A comprehensive analysis of jurisdiction-specific laws related to scheduling or required prescription drug monitoring of gabapentin in the United States, 2016-2024.The International journal on drug policy · 2026Article
- Joint call to action paper-Pain disparities special issues: Why this, why now? A unified call at a critical time.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026Article
- 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
- Medications for opioid use disorders among incarcerated persons and those in the community supervision setting: exploration of implementation issues with key stakeholders.Addiction science & clinical practice · 2024Article
- An updated view on the influence of initial opioid prescription characteristics on long-term opioid use among opioid naïve patients.Drug and alcohol dependence · 2024Article
- Nationally Representative Rates of Incident Prescription Opioid Use Among United States Adults and Selected Subpopulations: Longitudinal Cohort Study From the National Health Interview Survey, 2019 to 2020.The journal of pain · 2024Article
- Medicaid Expansion and Mortality Among Persons Who Were Formerly Incarcerated.JAMA network open · 2024Article
- Pain Research and Treatment: Policy Implications.Policy insights from the behavioral and brain sciences · 2024Article
- Changes in Surgical Opioid Prescribing and Patient-Reported Outcomes After Implementation of an Insurer Opioid Prescribing Limit.JAMA health forum · 2023Article
- "Cookbook medicine": Exploring the impact of opioid prescribing limits legislation on clinical practice and patient experiences.SSM. Qualitative research in health · 2023Article
- The Impact of Opioid Prescribing Limits on Drug Usage in South Carolina: A Novel Geospatial and Time Series Data Analysis.Healthcare (Basel, Switzerland) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe potential misapplication of current opioid prescribing policies remains understudied and may have substantial adverse implications for patient safety.
methodsWe used autoregressive integrated moving average models to assess level and trend changes in monthly 1) prescribing rates, 2) days' supply, and 3) daily morphine milligram equivalents (MME) of incident opioid prescriptions relative to 1) a state medical board initiative to reduce high-dose and -volume opioid prescribing and 2) legislation to limit initial opioid prescriptions for acute and postsurgical pain. We examined outcomes by pain indication overall and by cancer history, using prescribing patterns for benzodiazepines to control for temporal trends. We used large private health insurance claims data to include North Carolina residents, aged 18-64, insured at any point between January 2012 and August 2018.
resultsAfter the medical board initiative, prescribing patterns for chronic pain patients did not change; conversely, acute and postsurgical pain patients experienced immediate declines in daily MME. Post-legislation prescription rates did not decline for those with acute, postsurgical, and non-cancer pain, but instead declined among cancer patients with chronic pain. Chronic pain patients experienced the largest days' supply declines post-legislation, instead of acute and postsurgical pain patients.
conclusionsWe found mixed evidence on the potential impact of two opioid prescribing policies, with some observed declines in a group not intended to be impacted by the policy. This study provides evidence of the need for clearer opioid prescribing policies to ensure impacts on intended populations and avoid unintended consequences.
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.