Download or read book The Impact of Prescription Drug Monitoring Programs on U S Opioid Prescriptions written by Ian Ayres and published by . This book was released on 2018 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper seeks to understand the treatment effect of Prescription Drug Monitoring Programs (PDMPs) on opioid prescription rates. Using county-level panel data on all opioid prescriptions in the U.S. between 2006 and 2015, we investigate whether state interventions like PDMPs have heterogeneous treatment effects at the sub-state level, based on regional and temporal variations in policy design, extent of urbanization, race, and income. Our models comprehensively control for a set of county and time fixed effects, county-specific and time-varying demographic controls, potentially endogenous time-series trends in prescription rates, and other state-level opioid interventions such as Naloxone Access and Good Samaritan laws, Medicaid expansion, and the provision of Methadone Assistance Treatment. We find that PDMPs are only effective in reducing prescription rates if they obligate doctors to check for patients' history prior to filling out a prescription, but the frequency at which a state requires its PDMP to be updated is irrelevant to its effectiveness. Moreover, the significant treatment effects of PDMPs are almost exclusively driven by urban and predominantly white counties, with the relatively more affluent regions showing greater responsiveness than their less affluent counterparts.
Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-10-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Download or read book ARCOS written by United States. Drug Enforcement Administration and published by . This book was released on 1980 with total page 4 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Impact of Prescription Drug Monitoring Programs on the Dynamics of the Opioid Epidemic written by Samuel Gatley and published by . This book was released on 2017 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The forces driving the prescription opioid epidemic currently raging across the United States include aggressive marketing, weak regulation, addiction, freely prescribing doctors, a glut of pills available for sharing, and easy access to illicit drugs like heroin. This thesis aims to quantitatively analyze the interactions between these drivers through construction of a System Dynamics model, in order to determine the efficacy of policy intervention through Prescription Drug Monitoring Programs. The System Dynamics model simulates the flow of doctors’ prescriptions to the two very different classes of prescription opioid patients. One class is the long-term pain patients whose tolerance and appetite for opioids grows over time, leading them to higher doses, often dangerously high, and yet also frequently to feeling under-medicated; the other is those patients prescribed opioids for short-term pain, who typically find that they have been given more pills than they need. These 'extra' pills find their way into the hands of friends and family who, in common with the patients who received prescriptions, are in jeopardy of addiction to the opioids. Those addicted repeatedly visit doctors, shopping for more. Sensitivity analysis results reveal that drug diversion is a major contributor to the opioid death rate; that mandatory PDMP use will slow but not stop opioid proliferation, and will cause long term pain patients to be under-treated in larger numbers; that a significant number of people addicted to prescription opioids will transition to heroin use for reasons of price and availability; and that the rate of opioid overdose deaths will remain high until and unless society is better educated about the risks of addiction. Overall, the study helps conclude that the efforts of state governments and the FDA will be insufficient to stem the flow of opioids, and that there is no simple intervention to thwart drug diversion and sharing of pills."--Abstract.
Download or read book Factorial Survey Experiments written by Katrin Auspurg and published by SAGE Publications. This book was released on 2014-11-28 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: Filling a gap in the literature of the field, Factorial Survey Experiments provides researchers with a practical guide to using the factorial survey method to assess respondents’ beliefs about the world, judgment principles, or decision rules through multi-dimensional stimuli (“vignettes”) that resemble real-life decision-making situations. Using insightful examples to illustrate their arguments, authors Katrin Auspurg and Thomas Hinz guide researchers through all relevant steps, including how to set up the factorial experimental design (drawing samples of vignettes and respondents), how to handle the practical challenges that must be mastered when an experimental plan with many different treatments is embedded in a survey format, and how to deal with questions of data analysis. In addition to providing the “how-tos” of designing factorial survey experiments, the authors cover recent developments of similar methods, such as conjoint analyses, choice experiments, and more advanced statistical tools.
Download or read book Prescriptyion Opioid Analgesic Use Among Adults United States 1999 2012 written by Steven M. Frenk and published by . This book was released on 2015 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare written by Thomas C. Buchmueller and published by . This book was released on 2017 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: The misuse of prescription opioids has become a serious epidemic in the US. In response, states have implemented Prescription Drug Monitoring Programs (PDMPs), which record a patient's opioid prescribing history. While few providers participated in early systems, states have recently begun to require providers to access the PDMP under certain circumstances. We find that "must access" PDMPs significantly reduce measures of misuse in Medicare Part D. In contrast, we find that PDMPs without such provisions have no effect. We find stronger effects when providers are required to access the PDMP under broad circumstances, not only when they are suspicious.
Download or read book Medications for Opioid Use Disorder Save Lives written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-06-16 with total page 175 pages. Available in PDF, EPUB and Kindle. Book excerpt: The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
Download or read book The Effect of Prescription Drug Monitoring Programs on Opioid Prescriptions and Heroin Crime Rates written by Justine Mallatt and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Where Does It Hurt The Impact of Prescription Drug Monitoring Programs on Pain Management in Home Health Care written by Courtney Yarbrough and published by . This book was released on 2015 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: As states pass regulations to curb opioid abuse, what are the consequences for legitimate pain management? Forty-nine states have adopted prescription drug monitoring programs (PDMP) to detect potentially inappropriate opioid prescribing and use. Several studies have estimated the impact of PDMPs in reducing abuse and deaths. However, no study addresses an equally important question -- do PDMPs generate negative or positive spillover effects for pain management in the millions of Americans suffering from pain? We use 2003-2013 home health agency-level panel data to assess the effect of PDMPs on pain improvements in home health patients. We hypothesize that implementation of a PDMP in the context of home health care may induce agencies to substitute away from opioids to other (potentially more effective) treatments, such as physical therapy. Using a fixed effects, two-stage least squares model, we estimate pain improvements as a result of whether a state has implemented a PDMP and control for endogeneity between state policies and pain management practices. We find that home health agencies in states with PDMPs are on average more successful at improving pain in their patients. However, the effect varies according to how the agencies are reimbursed for services. Our results suggest that home health agencies are adapting their models of care to state opioid policies, and the incentives embedded in reimbursement systems can either promote better or worse pain management.
Download or read book Substance Use Disorders written by Gerard Moeller and published by Oxford University Press. This book was released on 2020-09-17 with total page 400 pages. Available in PDF, EPUB and Kindle. Book excerpt: Substance Use Disorders provides an overview of substance misuse and addresses the neurobiology, pharmacotherapy, and behavioural therapy management of substance use disorders from a clinical perspective. Examining the opioid epidemic to frame its discussion of the epidemiology of substance misuse, this book explores common barriers that prevent the implementation of effective treatment. Chapters discuss various aspects of substance use disorders, particularly opioids, alcohol, cannabis, and cocaine, to inform better conceptualization and management of these conditions. Part of the Primer On Psychiatry series, this book will provide a solid foundation for residents and fellows in psychiatry and addiction medicine and can also be used in clinical practice.
Download or read book Reverse Shoulder Arthroplasty written by Stefano Gumina and published by Springer. This book was released on 2018-11-29 with total page 365 pages. Available in PDF, EPUB and Kindle. Book excerpt: This handbook fully investigates reverse shoulder arthroplasty (RSA), presenting all the recent advances in the field to enable shoulder surgeons to treat patients with complex conditions, such as rotator cuff tears and instability, failed surgery and combined arthritis, or proximal humerus neoplasia. Reverse shoulder arthroplasty is becoming increasingly common because conventional total shoulder replacement may cause pain, loss of strength, simple or complex disabilities as well as limited motion, reducing general quality of life. The goal of a reverse prosthesis is to restore a painless, biomechanically valid joint. Drawing on the results of recent studies, the book covers all relevant aspects of RSA, including basic science, pathogenesis, clinical and instrumental evaluation, surgical techniques and complication management, helping readers to better understand when and how reverse shoulder arthroplasty should be implanted and what to do in cases of poor results. Written by leading shoulder specialists, the book provides surgeons and rehabilitation specialists, as well as residents and shoulder fellows, with a valuable, state-of-the-art guide for clinical practice.
Download or read book The Effects of Prescription Drug Monitoring Programs on Labor Market Activity and Credit Outcomes written by Sumedha Gupta and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: We examine how the availability of prescription opioids affects labor market activity and household economic well-being. While greater access to opioids may lead people to substance use disorders and negative economic consequences, appropriate pain medication may allow some individuals to effectively participate in the labor market. We study prescription drug monitoring programs (PDMPs), which were designed to curb inappropriate opioid prescribing and assess how these policies affected labor force attachment and credit outcomes. We use variation across states in the timing of implementation of PDMPs and recent methods developed for difference-in-difference event study designs with multiple time periods. In line with previous work, we find that PDMPs lead to a decline in opioid prescribing rates. Although we find that these reductions in opioid supply have no clear effect on measures of labor force activity in our pooled sample, we see some suggestive evidence of negative effects on labor force attachment in states where there is less scope for substitution to illicit drugs. We also show that PDMPs lead to a decline in credit scores and increases in the number and amount of third-party debt collections, and that these effects are more pronounced in states lacking an illicit market. These findings suggest that some individuals are likely negatively affected by the lack of access to pain medication due to the PDMP laws.
Download or read book Prescription Drug Abuse and Diversion written by United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions and published by . This book was released on 2005 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Effects of Opioid related Policies on Opioid Utilization Nature of Medical Care and Duration of Disability written by David Neumark and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: We examine the effects of must-access prescription drug monitoring programs (PDMPs) and recent regulations limiting the duration of initial opioid prescriptions on care received by patients with work-related injuries, focusing on opioid utilization and medical care related to pain management. We find that must-access PDMPs contributed to declines in opioid utilization, while regulations limiting duration of initial opioid prescriptions had little effect on whether workers receive opioids, but reduced opioid use among those with prescriptions. We find limited evidence that must-access PDMPs affected utilization of other medical care related to pain management, and that must-access PDMPs and limits on initial prescriptions had little impact on the duration of temporary disability benefits captured at 12 months of maturity.
Download or read book Relieving Pain in America written by Institute of Medicine and published by National Academies Press. This book was released on 2011-10-26 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
Download or read book Beyond Opioids written by David Beheshti and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A growing literature has examined how mandatory access prescription drug monitoring programs (MA PDMPs), laws that require providers to consider a patient's prescription history before prescribing controlled substances, affect opioid-related outcomes. However, little is known about their impact on non-opioid-related outcomes. In this paper, we examine the effect of MA PDMPs on prescribing patterns of stimulants and benzodiazepines. Using a difference-in-differences event study design, we show that MA PDMPs led to decreases in stimulant prescribing. In contrast, we find suggestive evidence that benzodiazepine prescriptions increase following the implementation of a MA PDMP. Our findings highlight that MA PDMPs do have effects on non-opioid drug prescribing, but these effects differ substantially across drug types.
