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Time and State Legislation Have Decreased Opioid Prescribing in Elective Foot and Ankle Surgery in the United States.

Publication ,  Journal Article
Cunningham, DJ; Kwon, NF; Allen, NB; Hanselman, AM; Adams, SB
Published in: Foot Ankle Spec
October 2023

BACKGROUND: Legislation in the United States has been enacted to reduce opioid overuse and abuse in the setting of the opioid epidemic, and a notable target has been opioid overprescription. However, the impact of this legislation on elective foot and ankle surgery is largely unknown. The purpose of this study was to evaluate the impact of opioid-limiting legislation on opioid prescribing in elective foot and ankle surgery. METHODS: The 90-day perioperative opioid prescription filling in oxycodone 5-mg equivalents was identified in all patients 18 years of age and older undergoing nontrauma, nonarthroplasty foot and ankle surgery from 2010 to 2019 using a commercial database. States with and without legislation were identified, and opioid prescription filling before and after the legislation were tabulated. Unadjusted and adjusted analyses were performed to evaluate the impact of time and state legislation on perioperative opioid prescribing in this patient population. RESULTS: Initial and cumulative opioid prescribing decreased significantly from 2010 to 2019 (39 vs 35.7 initial and 98.1 vs 55.7 cumulative). States with legislation had larger and more significant reductions in initial and cumulative opioid prescribing compared with states without legislation over similar time frames (41.6 to 35.1 with legislation vs 40.6 to 39.1 without legislation initial prescription filling volume and 87.7 to 62.8 vs 88.6 to 74.1 cumulative prescription filling volume). CONCLUSION: State legislation and time have been associated with large, clinically relevant reductions in 90-day perioperative cumulative opioid prescription filling, although reductions in initial opioid prescription filing have remained low. These results encourage states without legislation to enact restraints to reduce the opioid epidemic. LEVELS OF EVIDENCE: Level III: Retrospective, prognostic cohort study.

Duke Scholars

Published In

Foot Ankle Spec

DOI

EISSN

1938-7636

Publication Date

October 2023

Volume

16

Issue

5

Start / End Page

485 / 496

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cunningham, D. J., Kwon, N. F., Allen, N. B., Hanselman, A. M., & Adams, S. B. (2023). Time and State Legislation Have Decreased Opioid Prescribing in Elective Foot and Ankle Surgery in the United States. Foot Ankle Spec, 16(5), 485–496. https://doi.org/10.1177/19386400211043361
Cunningham, Daniel J., Nicholas F. Kwon, Nicholas B. Allen, Andrew M. Hanselman, and Samuel B. Adams. “Time and State Legislation Have Decreased Opioid Prescribing in Elective Foot and Ankle Surgery in the United States.Foot Ankle Spec 16, no. 5 (October 2023): 485–96. https://doi.org/10.1177/19386400211043361.
Cunningham DJ, Kwon NF, Allen NB, Hanselman AM, Adams SB. Time and State Legislation Have Decreased Opioid Prescribing in Elective Foot and Ankle Surgery in the United States. Foot Ankle Spec. 2023 Oct;16(5):485–96.
Cunningham, Daniel J., et al. “Time and State Legislation Have Decreased Opioid Prescribing in Elective Foot and Ankle Surgery in the United States.Foot Ankle Spec, vol. 16, no. 5, Oct. 2023, pp. 485–96. Pubmed, doi:10.1177/19386400211043361.
Cunningham DJ, Kwon NF, Allen NB, Hanselman AM, Adams SB. Time and State Legislation Have Decreased Opioid Prescribing in Elective Foot and Ankle Surgery in the United States. Foot Ankle Spec. 2023 Oct;16(5):485–496.
Journal cover image

Published In

Foot Ankle Spec

DOI

EISSN

1938-7636

Publication Date

October 2023

Volume

16

Issue

5

Start / End Page

485 / 496

Location

United States