CDC Guidelines May be Linked to Greater Declines in Opioid Prescribing

Opioid prescriptions have steadily decreased since 2012, but after the release of the CDC’s opioid prescribing guideline in 2016, several risky prescribing practices have declined at a significantly faster rate, according to research published in Annals of Internal Medicine.

“Data from patients prescribed opioids indicate a connection between prescribing practices and opioid-related harms and a need to optimize opioid prescribing,” Amy S.B. Bohnert, PhD, MHS, from University of Michigan and Veterans Affairs Center for Clinical Management Research, and colleagues wrote.

“In response to adverse outcomes from prescription opioids, the CDC released the Guideline for Prescribing Opioids for Chronic Pain in March 2016,” they added.

To investigate if the CDC guidelines were associated with reductions in specific opioid prescribing practices, Bohnert and colleagues analyzed data from the IQVIA transactional data warehouse and Real-World Data Longitudinal Prescriptions database from 2012 to 2017. They assessed opioid dosage, days supplied, overlapping benzodiazepine prescriptions and the overall rate of prescribing among patients prescribed opioid analgesics.

Opioid prescriptions have steadily decreased since 2012, but after the release of the CDC’s opioid prescribing guideline in 2016, several risky prescribing practices have declined at a significantly faster rate.
Source: Adobe Stock

The researchers found that in January 2012, 683 per 100,000 persons were prescribed high-doses of opioids, defined as 90 or more morphine equivalent mg per day. This rate decreased by 3.56 persons (95% CI, –3.79 to –3.32) per month before the CDC guideline release and by 8 (95%CI, –8.69 to –7.31) afterward.

At the start of 2012, 21.04% of patients had overlapping opioid and benzodiazepine prescriptions. Before March 2016, this percentage declined by 0.02% (95% CI, –0.04 to –0.01) per month, then by 0.08% (95% CI, –0.08 to –0.07) per month afterward.

The overall opioid prescribing rate also decreased from 2012 to 2017. The rate was 6,577 per 100,000 persons in January 2012, declining by 23.48 (95% CI, –26.18 to –20.78) each month before the guideline release and by 56.74 (95% CI, –65.96 to –47.53) per month afterward.

“These findings suggest that the guideline release may have contributed to better prescribing behaviors,” Bohnert and colleagues concluded.

“The opioid overdose epidemic is a complex crisis that requires a response from several sectors, including public health, health care, and public safety,” they added. “System-level interventions should be implemented in the context of a comprehensive approach targeting the drivers of the epidemic.” – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.

Opioid prescriptions have steadily decreased since 2012, but after the release of the CDC’s opioid prescribing guideline in 2016, several risky prescribing practices have declined at a significantly faster rate, according to research published in Annals of Internal Medicine.

“Data from patients prescribed opioids indicate a connection between prescribing practices and opioid-related harms and a need to optimize opioid prescribing,” Amy S.B. Bohnert, PhD, MHS, from University of Michigan and Veterans Affairs Center for Clinical Management Research, and colleagues wrote.

“In response to adverse outcomes from prescription opioids, the CDC released the Guideline for Prescribing Opioids for Chronic Pain in March 2016,” they added.

To investigate if the CDC guidelines were associated with reductions in specific opioid prescribing practices, Bohnert and colleagues analyzed data from the IQVIA transactional data warehouse and Real-World Data Longitudinal Prescriptions database from 2012 to 2017. They assessed opioid dosage, days supplied, overlapping benzodiazepine prescriptions and the overall rate of prescribing among patients prescribed opioid analgesics.

Opioid prescriptions have steadily decreased since 2012, but after the release of the CDC’s opioid prescribing guideline in 2016, several risky prescribing practices have declined at a significantly faster rate.
Source: Adobe Stock

The researchers found that in January 2012, 683 per 100,000 persons were prescribed high-doses of opioids, defined as 90 or more morphine equivalent mg per day. This rate decreased by 3.56 persons (95% CI, –3.79 to –3.32) per month before the CDC guideline release and by 8 (95%CI, –8.69 to –7.31) afterward.

At the start of 2012, 21.04% of patients had overlapping opioid and benzodiazepine prescriptions. Before March 2016, this percentage declined by 0.02% (95% CI, –0.04 to –0.01) per month, then by 0.08% (95% CI, –0.08 to –0.07) per month afterward.

The overall opioid prescribing rate also decreased from 2012 to 2017. The rate was 6,577 per 100,000 persons in January 2012, declining by 23.48 (95% CI, –26.18 to –20.78) each month before the guideline release and by 56.74 (95% CI, –65.96 to –47.53) per month afterward.

“These findings suggest that the guideline release may have contributed to better prescribing behaviors,” Bohnert and colleagues concluded.

“The opioid overdose epidemic is a complex crisis that requires a response from several sectors, including public health, health care, and public safety,” they added. “System-level interventions should be implemented in the context of a comprehensive approach targeting the drivers of the epidemic.” – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.

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