Pacific AB
Using mixed-methods to inform synthetic control analysis of four types of state laws intended to curb high-risk opioid prescribing (306550)
*Beth McGinty, Johns Hopkins Bloomberg School of Public HealthKeywords: synthetic control, mixed-methods, opioid, law, policy
The U.S. opioid crisis has been driven by opioid over prescribing. In response, states have recently enacted four primary types of state laws: mandatory prescription drug monitoring program (PDMP) enrollment laws; mandatory PDMP query laws; pill mill laws regulating pain management clinics; and opioid prescribing cap laws. The independent effects of these laws on opioid prescribing are poorly understood and there is concern in the medical community that these laws may adversely affect people with chronic non-cancer pain. Using synthetic control analyses of IQVIA claims data, we evaluate the independent effects of each of these four types of state laws on measures of high-risk opioid prescribing and measures of receipt of guideline-concordant, non-opioid treatment for chronic non-cancer pain. The results of 115 qualitative interviews with state law implementation and enforcement leaders informed design and interpretation of synthetic control analyses. Results suggest that rigorously implemented and enforced mandatory PDMP query and opioid prescribing cap laws reduce opioid prescribing but have no effects on chronic pain patients' receipt of non-opioid alternatives.