How One State Reduced the Number of Opioid Prescriptions in Just One Year

The number of opioid-related deaths nearly quadrupled from 1999 to 2011 in the US; and while that number continues to increase, one state has made positive strides with the implementation of two initiatives.

In April 2015, a report revealed that the two Florida laws caused a 25% decrease in oxycodone-related deaths. A new analysis from researchers at the Johns Hopkins Bloomberg School of Public Health found that together the restrictions also caused a decline in opioid prescriptions within just a 12-month span.

The Prescription Drug Monitoring Program called E-FORCSE (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program) tracks prescriptions for each patient regarding the date and amount in order to red flag physicians to those who may be misusing the drugs. The program was launched in late 2011 and began showing notable results by 2012. The second initiative required clinics to be owned by a physician and registered with the state. This reduced the so-called “pill mills” that often produced a large volume of opioid prescriptions.

The team used data gathered from prescribers, retail pharmacies, and patients to compare prescription information in Florida and Georgia (used as a control state for the study). Collected from July 2010 to September 2012, the figures showed total opioid volume, average amount of days supplied per transaction, total number of opioid prescriptions dispensed, and average morphine milligram equivalent (MME) per transaction.

There were about 480 million prescriptions (7.7% for opioids) between the two states. Before the laws were put into place, Florida had a higher amount of prescriptions as well as more opioid volume, MME per transaction, and amount of days supplied per transaction. However, 12 months after the restrictions were implemented, Florida showed a decrease in opioid volume by 2.5% — about 750,000 pills each month. In addition, there was a drop in opioid prescriptions (1.4%)and MME per transaction (5.6%).

“Florida’s laws were associated with statistically significant declines in opioid volume (2.5 kg/mo, P < .05; equivalent to approximately 500 000 5-mg tablets of hydrocodone bitartrate per month) and MME per transaction (0.45 mg/mo, P < .05), without any changes in days’ supply,” the authors wrote in JAMA Internal Medicine.

The largest decrease was observed in prescribers and patients with the highest baseline. Although there were limitations in the analysis such as varying time windows and enrollment criteria, the noteworthy decrease in opioid prescribing and usage is credited to the two laws.

“These findings support the notion that there are policy solutions to the prescription drug epidemic,” one of the authors Lainie Rutkow, JD, MPH, PhD, an associate professor in the Department of Health Policy and Management at the school, said in a news release.