How state policies impacted the number of opioid poisonings

July 15, 2020

The opioid epidemic led many state policies to reduce opioid use. A report looks at the impact of these policies on opioid poisonings.

The opioid epidemic led to many changes regarding when opioids are prescribed, how long opioid prescriptions would run, and other changes. Many of these changes came about as policies at the state government level. A report in JAMA Pediatrics examines whether these state-level opioid-reduction policies led to a decrease in opioid poisonings among children and adolescents.1

Investigators did an interrupted time series analysis using data from the National Poison Data System, a database of poisoning information sent to poison control centers across the United States. People aged younger than 20 years who had a poisoning incident that was linked to 1 or more prescription opioids from January 2000 to November 2017 were used in their analysis. They focused on 3 policy interventions: opioid prescription guidelines, prescription drug monitoring program, and pain clinic legislation.

There were 338,476 opioid poisoning incidences among children and young adults reported to the National Poison Data System during the study period. The average age of the population was 9.74 years and 179,011 of them were girls. Implementing a prescription drug monitoring program led to a reduction in the monthly rate of opioid poisoning (–0.07 per million person-months) during the postimplementation period. The reduction was seen in all age groups, except for the 10- to 14- year age group. Pain clinic legislation was tied to an immediate reduction in opioid poisoning (–6.22 per million person-months) and was statistically significant except in the age group of 4 years of younger. Insufficient follow-up data limited the analysis of the impact of implementing opioid prescribing guidelines.

The researchers concluded that some policies were linked to decreases in opioid exposures. They said that further study could discover the mechanisms behind the associations.

Reference

1. Toce MS, Michelson K, Hudgins J, Burns MM, Monuteaux MC, Bourgeois FT. Association of state-level opioid-reduction policies with pediatric opioid poisoning. JAMA Pediatr. July 13, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.1980