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Cited by 273Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesPharmaceutical Practices and Patient Outcomes

What we know, and don't know, about the impact of state policy and systems-level interventions on prescription drug overdose

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Haegerich, Tamara M., Paulozzi, Leonard J., Manns, Brian J., Jones, Christopher M.·2014·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2014.10.001PMC PMC6557270
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Abstract

Background Drug overdose deaths have been rising since the early 1990s and is the leading cause of injury death in the United States. Overdose from prescription opioids constitutes a large proportion of this burden. State policy and systems-level interventions have the potential to impact prescription drug misuse and overdose.Methods We searched the literature to identify evaluations of state policy or systems-level interventions using non-comparative, cross-sectional, before-after, time series, cohort, or comparison group designs or randomized/non-randomized trials. Eligible studies examined intervention effects on provider behavior, patient behavior, and health outcomes.Results Overall study quality is low, with a limited number of time-series or experimental designs. Knowledge and prescribing practices were measured more often than health outcomes (e.g., overdoses). Limitations include lack of baseline data and comparison groups, inadequate statistical testing, small sample sizes, self-reported outcomes, and short-term follow-up. Strategies that reduce inappropriate prescribing and use of multiple providers and focus on overdose response, such as prescription drug monitoring programs, insurer strategies, pain clinic legislation, clinical guidelines, and naloxone distribution programs, are promising. Evidence of improved health outcomes, particularly from safe storage and disposal strategies and patient education, is weak.Conclusions While important efforts are underway to affect prescriber and patient behavior, data on state policy and systems-level interventions are limited and inconsistent. Improving the evidence base is a critical need so states, regulatory agencies, and organizations can make informed choices about policies and practices that will improve prescribing and use, while protecting patient health.

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Research works printed but not linked: 5

  1. Brason F, Roe C, Dasgupta N, 2013 Project Lazarus: an innovative community response to prescription drug overdose. N.C. Med.J. 74, 259– 261. 23940903
  2. Centers for Disease Control and Prevention, 2013 Patient Review and Restriction Programs: Lessons Learned From State Medicaid Programs. CDC, Atlanta, GA.
  3. Florida Medicaid, 2005 Medicaid prescribed drug spending control program initiatives: quarterly report January 1-March 31, 2005. Tallahassee, FL.
  4. Ma C, Batz F, Juarez D, Ladao L, 2004 Drug take back in Hawaii: partnership between the University of Hawaii Hilo College of Pharmacy and the Narcotics Enforcement Division. Hawaii J. Med. Public Health 73, 26– 31 (accessed 11.09.14) http://msa.maryland.gov/megafile/msa/speccol/sc5300/sc5339/000113/012000/012478/unrestricted/20100355e.pdf PMC3901169 24470984
  5. Tanenbaum S, Dyer J, 1990 The dynamics of prescription drug abuse and its correctives in one state Medicaid program In: Wilford BB (Ed.), Balancing the Response to Prescription Drug Abuse. American Medical Association, Chicago, pp. 229– 238.

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Authors
Haegerich, T. M., Paulozzi, L. J., Manns, B. J., & Jones, C. M.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • United States Food and Drug Administration (US)
Corresponding author
Haegerich, Tamara M.
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2014-12
Volume
145
Pages
34-47
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2014.10.001
PMC
PMC6557270
OpenAlex
W2035786417
Cited by
272
References
115
Citations by year
2026: 1 · 2025: 6 · 2024: 3 · 2023: 10 · 2022: 16 · 2021: 20 · 2020: 18 · 2019: 54 · 2018: 42 · 2017: 38 · 2016: 41 · 2015: 22
FWCI
5.30
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (CC999999)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
prescription drug overdose, prescription opioid misuse, state policy, system-level interventions, prescription drug monitoring programs, naloxone distribution, clinical guidelines, inappropriate prescribing, overdose response, patient education, health outcomes, provider behavior
MeSH terms
Analgesics, Opioid, Clinical Trials as Topic, Cross-Sectional Studies, Health Policy, Humans, United States, Cohort Studies, Prescription Drugs, Inappropriate Prescribing, Drug Overdose

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