Outcomes of Opioid Misuse Prevention Policies

The Association of State Opioid Misuse Prevention Policies With Patient- and Provider-Related Outcomes: A Scoping Review – Dec 2019

Policy Points:

  • This scoping review reveals a growing literature on the effects of certain state opioid misuse prevention policies, but persistent gaps in evidence on other prevalent state policies remain.
  • [I had to skip the 2nd “policy point” because it was so absurd, again urging restrictions on prescribed opioids, which are NOT the problem]
  • Further research should concentrate on potential unintended consequences of opioid misuse prevention policies, differential policy effects across populations, interventions that have not received sufficient evaluation (eg, Good Samaritan laws, naloxone access laws), and patient-related outcomes.

Methods:

We searched six online databases to identify evaluations of state opioid policies. Eligible studies examined legislative and administrative policy interventions that evaluated

(a) prescribing and dispensing,
(b) patient behavior, or
(c) patient health.

Findings:

Seventy-one articles met our inclusion criteria, including 41 studies published between 2016 and 2018.

These articles evaluated nine types of state policies targeting opioid misuse.

While prescription drug monitoring programs (PDMPs) have received considerable attention in the literature, far fewer studies addressed other types of state policy.

Overall, evidence quality is very low for the majority of policies due to a small number of evaluations.

RIght in the guideline itself, the CDC claimed it would collect data on the outcomes of this ridiculous guideline, yet they simply did not. They have deliberately avoided collecting any data on the damage done to patients.

The outcomes for patients force-tapered as a misapplication of the guideline have simply been ignored.

Of interventions that have been the subject of considerable research, promising means of reducing the volume and dosages of opioids prescribed and dispensed include drug supply management policies and robust PDMPs.

Due to low study number and quality, evidence is insufficient to draw conclusions regarding interventions targeting patient behavior and health outcomes, including naloxone access laws and Good Samaritan laws.

Conclusions:

Recent research has improved the evidence base on several state interventions targeting opioid misuse.

Specifically, moderate evidence suggests that drug supply management policies and robust PDMPs reduce opioid prescribing.

But prescribing isn’t the problem; the problem is addiction and overdose caused by multiple drugs (polypharmacy), especially illicit fentanyl being mixed into all kinds of other drugs.

By looking only at this “surrogate endpoint” they are missing the critical aspect of the problem: illicit opioid abuse, not legitimate opioid use.

Despite the increase in rigorous evaluations, evidence remains limited for the majority of policies, particularly those targeting patient health–related outcomes.

1 thought on “Outcomes of Opioid Misuse Prevention Policies

  1. Kathy C

    Watching the C-Span coverage of the so called “Opioid Epidemic” in the Senate, is quite enlightening. A number of our elected officials are carefully avoiding key questions. They are throwing around statistics to make themselves sound in the know. Senator Feinstein asked about a breakdown in the demographics, which no agency has available. When they break down the numbers, they are not quite as impressive, and they have to protect the pharma industry from the Poly Pharmacy aspect in so called “overdose deaths.”

    They keep attacking the DEA, making themselves sound clever. They still refuse to acknowledge how the DEA was not allowed to collect data, on the industries that profited. The DEA was going after patients and physicians for the last 20 years, but it was hands off of the industry.

    They are expressing their “Bi Partisan Outrage,” yet they continue with misleading statistics, and their heads in the sand. They want to avoid discussing how the CDC failed our populace. All of our regulatory agencies failed because they are still refusing to look at corporate influence, Regulatory Capture, and the breakdown of or healthcare system, due to market forces.

    Dr Grandotra at SAMHSA, claims that “Education” and”Evidence Based” practices are being used. This is clearly gas lighting, since at no time did they even collect meaningful data, nor require treatment, when it was evident there were Americans who were addicted.

    My Hero! Sen Sheldon Whitehouse just asked about the Gulliani Perdue lawsuit, which set the stage for the industry protection for all of these years. Of course a representative on one of the Opioid Task-forces, has no idea that even existed. The media has been careful to avoid covering that story, in order to protect industry profits. Our politicians except for Whitehouse , remain blissfully unaware of how the very corporations they took money from undermined our regulatory agencies.

    We do not see any effort by SAMHSA or any agency fighting misinformation, fake news or deceptive media misreporting on public health issues. We see the same nonsense and political grandstanding that has been occurring for 2 decades.

    Sen Coons claims this is a “Genuine National Crisis” but the denial remains. They did not even touch on legitimate medical use for any of these drugs. It is all like “Closing the barn door after the horses get out.” My state claimed it was “at the forefront” because they were dealing with a heroin problem since the 1990’s. They used the same denial, selective sensationalization, and self serving marketing on that problem that continues to this day. They ensured this problem would be generational.

    Let’s blame everyone but the ones responsible, and forget about facts and data. Unfortunately the guy from the DEA, cannot explain how math works to Sen Kennedy. Sen Kennedy got on his soap box about the “8 Billion Pills” and he claims he does not speak B.S.” Of course the good Senator “forgot” that his good buddy Rudy Gulliani protected the industry from DEA data collection. Now he wants to go after the doctors, with a deceptive line taken straight from Perdue’s marketing/propaganda campaign.

    The future of this country is in the hands of these willfully ignorant compromised elected representatives.

    Like

    Reply

Other thoughts?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.