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How Have State Opioid Limits Affected Post-Surgery Prescribing?

MedicalResearch.com Interview with:
Sunil Agarwal, MD
Michigan Opioid Prescribing Engagement Network
Ann Arbor, MI

MedicalResearch.com: What is the background for this study?

Response: Excess opioid prescribing after surgery often leads to misuse and diversion into the community.

To prevent excessive prescribing for acute pain, 31 states have implemented legislation that limits the duration of opioid prescriptions. Our study examined the effect of prescribing limits and postoperative opioid prescribing on surgical patients in Massachusetts and Connecticut, the first two states to implement opioid prescribing limits for acute pain after the CDC guidelines were released. 

MedicalResearch.com: What are the main findings? 

Response: Our results suggest that opioid duration limits had a variable association with postoperative opioid prescribing in Massachusetts and Connecticut. The mean opioid prescription size filled, duration supplied, and prescribing exceeding a seven-day supply decreased after limit implementation in Massachusetts, but not in Connecticut. Even in Massachusetts, the magnitude of the observed changes were small, and the amount of opioid prescribed still exceeded the average amount used by patients after surgery.

MedicalResearch.com: What should readers take away from your report?

Response: Our results suggest that prescribing limits have variable association with postoperative opioid prescribing and should only be part of a larger, multifaceted effort to reduce excessive postoperative opioid prescribing.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Future directions include the development and implementation of evidence-based prescribing guidelines based on patient-reported opioid-related outcomes. Legislative interventions should be paired with evidence-based guidelines to yield safe and effective management of postoperative pain.

I do not have any disclosures to report at this time.


Agarwal S, Bryan JD, Hu HM, et al. Association of State Opioid Duration Limits With Postoperative Opioid Prescribing. JAMA Netw Open. 2019;2(12):e1918361. doi:https://doi.org/10.1001/jamanetworkopen.2019.18361



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Last Updated on December 30, 2019 by Marie Benz MD FAAD