PDF(Pubmed)
Abstract：
State policies can impact opioid prescribing or dispensing. Some state opioid policies have been widely examined in empirical studies, including prescription drug monitoring programs and pain clinic licensure requirements. Other relevant policies might exist that have received limited attention. Our objective was to identify and categorize a wide range of state policies that could affect opioid prescribing/dispensing.
We used stratified random sampling to select 16 states and Washington, DC, for our sample. We collected state regulations and statutes effective during 2020 from each jurisdiction, using search terms related to opioids, pain management, and prescribing/dispensing. We then conducted qualitative template analysis of the data to identify and categorize policy categories.
We identified three dimensions of opioid prescribing/dispensing laws: the prescribing/dispensing rule, its applicability, and its disciplinary consequences. Policy categories of prescribing/dispensing rules included clinic licensure, staff credentials, evaluating the appropriateness of opioids, limiting the initiation of opioids, preventing the diversion or misuse of opioids, and enhancing patient safety. Policy categories related to applicability of the law included the pain type, substance type, practitioner, setting, payer, and prescribing situation. The disciplinary consequences dimension included specific consequences and inspection processes.
Policy categories within each dimension of opioid prescribing/dispensing laws could become a foundation for creating variables to support empirical analyses of policy effects, improving operationalization of policies in empirical studies, and helping to disentangle the effects of multiple state laws enacted at similar times to address the opioid crisis. Several of the policy categories we identified have been underexplored in previous empirical studies.
We used stratified random sampling to select 16 states and Washington, DC, for our sample. We collected state regulations and statutes effective during 2020 from each jurisdiction, using search terms related to opioids, pain management, and prescribing/dispensing. We then conducted qualitative template analysis of the data to identify and categorize policy categories.
We identified three dimensions of opioid prescribing/dispensing laws: the prescribing/dispensing rule, its applicability, and its disciplinary consequences. Policy categories of prescribing/dispensing rules included clinic licensure, staff credentials, evaluating the appropriateness of opioids, limiting the initiation of opioids, preventing the diversion or misuse of opioids, and enhancing patient safety. Policy categories related to applicability of the law included the pain type, substance type, practitioner, setting, payer, and prescribing situation. The disciplinary consequences dimension included specific consequences and inspection processes.
Policy categories within each dimension of opioid prescribing/dispensing laws could become a foundation for creating variables to support empirical analyses of policy effects, improving operationalization of policies in empirical studies, and helping to disentangle the effects of multiple state laws enacted at similar times to address the opioid crisis. Several of the policy categories we identified have been underexplored in previous empirical studies.
摘要：
目标：国家政策可能会影响阿片类药物处方或配药。一些州的阿片类药物政策已经在实证研究中得到了广泛的检验，包括处方药监测计划和疼痛诊所执照要求。可能存在其他受到有限关注的相关政策。我们的目标是确定和分类可能影响阿片类药物处方/配药的广泛国家政策。
方法：我们使用分层随机抽样选择了16个州和华盛顿州，DC,我们的样品。我们从每个司法管辖区收集了2020年生效的国家法规和法规，使用与阿片类药物相关的搜索词，疼痛管理,和处方/分配。然后，我们对数据进行了定性模板分析，以识别和分类政策类别。
结果：我们确定了阿片类药物处方/配药法律的三个维度：处方/配药规则，其适用性，及其纪律后果。处方/配药规则的政策类别包括诊所执照，工作人员证书，评估阿片类药物的适当性，限制阿片类药物的启动，防止阿片类药物的转移或滥用，提高患者安全。与法律适用性相关的政策类别包括疼痛类型，物质类型,从业者，设置,付款人,和规定的情况。纪律后果维度包括具体后果和检查过程。
结论：阿片类药物处方/分配法律的每个维度中的政策类别可能成为创建变量以支持政策效果的实证分析的基础。在实证研究中提高政策的可操作性，并帮助解开在类似时期颁布的多个州法律的影响，以解决阿片类药物危机。我们确定的几个政策类别在以前的实证研究中没有得到充分的探索。
方法：我们使用分层随机抽样选择了16个州和华盛顿州，DC,我们的样品。我们从每个司法管辖区收集了2020年生效的国家法规和法规，使用与阿片类药物相关的搜索词，疼痛管理,和处方/分配。然后，我们对数据进行了定性模板分析，以识别和分类政策类别。
结果：我们确定了阿片类药物处方/配药法律的三个维度：处方/配药规则，其适用性，及其纪律后果。处方/配药规则的政策类别包括诊所执照，工作人员证书，评估阿片类药物的适当性，限制阿片类药物的启动，防止阿片类药物的转移或滥用，提高患者安全。与法律适用性相关的政策类别包括疼痛类型，物质类型,从业者，设置,付款人,和规定的情况。纪律后果维度包括具体后果和检查过程。
结论：阿片类药物处方/分配法律的每个维度中的政策类别可能成为创建变量以支持政策效果的实证分析的基础。在实证研究中提高政策的可操作性，并帮助解开在类似时期颁布的多个州法律的影响，以解决阿片类药物危机。我们确定的几个政策类别在以前的实证研究中没有得到充分的探索。
