@article{993, author = {Amy S B Bohnert and Gery P. Guy and Jan L. Losby}, title = {Opioid prescribing in the United States before and after the Centers for Disease Control and Prevention's 2016 opioid guideline}, abstract = {

Background: In response to adverse outcomes from prescription opioids, the Centers for Disease Control and Prevention (CDC) released the Guideline for Prescribing Opioids for Chronic Pain in March 2016.

Objective: To test the hypothesis that the CDC guideline release corresponded to declines in specific opioid prescribing practices.

Design: Interrupted time series analysis of monthly prescribing measures from the IQVIA transactional data warehouse and Real-World Data Longitudinal Prescriptions population-level estimates based on retail pharmacy data. Population size was determined by U.S. Census monthly estimates.

Setting: United States, 2012 to 2017.

Patients: Persons prescribed opioid analgesics.

Measurements: Outcomes included opioid dosage, days supplied, overlapping benzodiazepine prescriptions, and the overall rate of prescribing.

Results: The rate of high-dosage prescriptions (≥90 morphine equivalent milligrams per day) was 683 per 100 000 persons in January 2012 and declined by 3.56 (95% CI, -3.79 to -3.32) per month before March 2016 and by 8.00 (CI, -8.69 to -7.31) afterward. Likewise, the percentage of patients with overlapping opioid and benzodiazepine prescriptions was 21.04% in January 2012 and declined by 0.02% (CI, -0.04% to -0.01%) per month before the CDC guideline release and by 0.08% (CI, -0.08% to -0.07%) per month afterward. The overall opioid prescribing rate was 6577 per 100 000 persons in January 2012 and declined by 23.48 (CI, -26.18 to -20.78) each month before the guideline release and by 56.74 (CI, -65.96 to -47.53) per month afterward.

Limitation: No control population; inability to determine the appropriateness of opioid prescribing.

Conclusion: Several opioid prescribing practices were decreasing before the CDC guideline, but the time of its release was associated with a greater decline. Guidelines may be effective in changing prescribing practices.

Primary Funding Source: CDC.

}, year = {2018}, journal = {Ann Intern Med}, volume = {169}, pages = {367-375}, month = {12/2018}, issn = {1539-3704}, doi = {10.7326/M18-1243}, language = {eng}, }