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Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States.

Publication ,  Journal Article
Cunningham, DJ; Ryan, SP; George, SZ; Lewis, BD
Published in: Subst Abuse Treat Prev Policy
September 28, 2021

BACKGROUND: The opioid misuse epidemic focused national attention on reducing opioid overprescribing. The purpose of this study is to describe the relationship of time and state-level interventions and opioid filling surrounding total hip arthroplasty (THA) in the United States. METHODS: A national database with diverse insurance constituents was queried for first-prescription and cumulative perioperative opioid filling volumes and rates in oxycodone 5-mg equivalents (OE's) in 487,942 patients undergoing primary THA from 30-days pre-operative to 90-days post-operative. Descriptive statistics evaluated pre-legislative and post-legislative opioid filling by state, legislative type, and surgery year. RESULTS: At the national level, initial opioid filling volumes have remained largely unchanged (56.2 OE's in 2010 to 51.7 OE's in 2018). Meanwhile, cumulative opioid filling volumes (151.9 OE's in 2010 to 111.7 OE's in 2018) have decreased considerably. Rates of initial opioid prescriptions exceeding 90 OE's were similar in 2010 (6.4%) and 2018 (5.6%). States with legislation targeting duration and volume of opioid prescriptions saw the largest decreases in opioid prescription filling. That is, 75% of states with opioid legislation had large (> 10 oxycodone 5-mg equivalents) decreases in cumulative 90-day opioid filling compared to only 20% of states without opioid legislation having large decreases in cumulative 90-day opioid filling. CONCLUSIONS: This descriptive study demonstrates decreases in perioperative opioid filling for THA. Although this study was descriptive in nature, states enacting opioid-limiting legislation had larger decreases. Although causal relationships could not be inferred from this analysis, the results suggest that states without legislation could improve prescriber compliance with national goals of decreased opioid overprescribing by enacting opioid-limiting legislation. LEVEL OF EVIDENCE: Level III, retrospective prognostic cohort study.

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Published In

Subst Abuse Treat Prev Policy

DOI

EISSN

1747-597X

Publication Date

September 28, 2021

Volume

16

Issue

1

Start / End Page

75

Location

England

Related Subject Headings

  • United States
  • Substance Abuse
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Pain, Postoperative
  • Narcotics
  • Humans
  • Cohort Studies
  • Arthroplasty, Replacement, Hip
  • Analgesics, Opioid
 

Citation

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Cunningham, D. J., Ryan, S. P., George, S. Z., & Lewis, B. D. (2021). Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States. Subst Abuse Treat Prev Policy, 16(1), 75. https://doi.org/10.1186/s13011-021-00410-w
Cunningham, Daniel J., Sean P. Ryan, Steven Z. George, and Brian D. Lewis. “Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States.Subst Abuse Treat Prev Policy 16, no. 1 (September 28, 2021): 75. https://doi.org/10.1186/s13011-021-00410-w.
Cunningham DJ, Ryan SP, George SZ, Lewis BD. Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States. Subst Abuse Treat Prev Policy. 2021 Sep 28;16(1):75.
Cunningham, Daniel J., et al. “Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States.Subst Abuse Treat Prev Policy, vol. 16, no. 1, Sept. 2021, p. 75. Pubmed, doi:10.1186/s13011-021-00410-w.
Cunningham DJ, Ryan SP, George SZ, Lewis BD. Opioid legislation and narcotic filling in total hip arthroplasty: descriptive study of time and state-level trends in the United States. Subst Abuse Treat Prev Policy. 2021 Sep 28;16(1):75.
Journal cover image

Published In

Subst Abuse Treat Prev Policy

DOI

EISSN

1747-597X

Publication Date

September 28, 2021

Volume

16

Issue

1

Start / End Page

75

Location

England

Related Subject Headings

  • United States
  • Substance Abuse
  • Retrospective Studies
  • Practice Patterns, Physicians'
  • Pain, Postoperative
  • Narcotics
  • Humans
  • Cohort Studies
  • Arthroplasty, Replacement, Hip
  • Analgesics, Opioid