In the first year that two Florida laws aimed at curbing opioid prescriptions were in effect, the state’s top opioid prescribers wrote significantly fewer prescriptions of this type of pain medication, a new analysis led by researchers at the Johns Hopkins University Bloomberg School of Public Health finds.
At the same time, the law did not affect the extreme concentration of opioid prescribing among a small group of providers: Approximately 4 percent of prescribers accounted for 40 percent of the prescriptions for opioid painkillers that made up two-thirds of all such pills prescribed in Florida. Primary care physicians made up more than half of the top prescribers. These findings suggests both the potential impact of policies at curtailing prescriptions among high-volume prescribers and the limits of the new policies, since many physicians still prescribed at high rates.
The new analysis followed patients and prescribers from July 2010 through November 2012; the two policies were implemented in late 2011. The first policy created the state’s Prescription Drug Monitoring Program (PDMP), a database that tracks individual prescriptions, including patient names, dates and amounts prescribed, so physicians can be on the lookout for people with multiple prescriptions from multiple doctors, something associated with addiction and illicit use. The second law addressed so-called “pill mills,” loosely regulated pain clinics that often see disproportionately high levels of opioid prescriptions. Florida’s “pill mill” measure requires clinics to register with the state and to be owned by a physician.
During the one-year period after the law went into effect, the researchers estimate that opioid prescriptions by Florida’s top opioid prescribers fell 6.2 percent and the total volume prescribed by this group dropped 13.5 percent (compared to a scenario in which the laws were not implemented). In this group, the number of patients also dropped, by 5.1 percent. (The top four percent included 1,526 providers out of a total of 38,465 in the state.) Among the remaining 96 percent of prescribers, prescriptions slipped a mere 0.7 percent.