Postop opioid scripts rise despite DEA schedule change

  • JAMA Surg

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • A policy passed by the US Drug Enforcement Agency (DEA) in 2014 aimed at reducing opioid prescribing through hydrocodone restriction was associated with a significant increase in the amount of opioids filled in the initial prescription immediately after elective surgery, no change in the overall amount of opioids prescribed within 30 days of surgery, and a decrease in the rate of opioid prescription refills.

Why this matters

  • The DEA changed hydrocodone-containing products from schedule III of the Controlled Substances Act to schedule II in 2014, limiting commonly prescribed formulations of hydrocodone to a 90-day supply.

Study design

  • Retrospective study of 21,955 patients who received opioid prescription after surgery and 5120 prescribers.
  • Funding: National Institute on Drug Abuse.

Key results

  • A significant increase in mean oral morphine equivalents (OMEs) filled in the initial opioid prescription immediately after surgery was observed after the schedule change (35 OMEs; P<.011>
  • After the schedule change, no significant difference observed in the total OMEs filled during the 30-day postoperative period before and after the surgery (P=.55).
  • After the schedule change, the refill rate decreased 5.19% (P<.001 for all patients and opioid-naive patients.>

Limitations

  • Data were obtained from a single state.

Coauthored with Anand Ramanathan, PharmD

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