{Reference Type}: Journal Article
{Title}: State-level policies and receipt of CDC-informed opioid thresholds among commercially insured new chronic opioid users.
{Author}: Calabrese MJ;Shaya FT;Palumbo F;McPherson ML;Villalonga-Olives E;Zafari Z;Mutter R;
{Journal}: J Opioid Manag
{Volume}: 20
{Issue}: 2
{Year}: 2024 Mar-Apr
暂无{DOI}: 10.5055/jom.0824
{Abstract}: <B>OBJECTIVE: </B>To evaluate the association of state-level policies on receipt of opioid regimens informed by Centers for Disease Control and Prevention (CDC) morphine milligram equivalent (MME)/day recommendations.<BR><B>METHODS: </B>A retrospective cohort study of new chronic opioid users (NCOUs).<BR><B>METHODS: </B>Commercially insured plans across the United States using IQVIA PharMetrics® Plus for Academics database with new chronic use between January 2014 and March 2015.<BR><B>METHODS: </B>NCOUs with ≥60-day coverage of opioids within a 90-day period with ≥30-day opioid-free period prior to the date of the first qualifying opioid prescription.<BR><B>METHODS: </B>State-level policies including Prescription Drug Monitoring Program (PDMP) robustness and cannabis policies involving the presence of medical dispensaries and state-wide decriminalization.<BR><B>METHODS: </B>NCOUs were placed in three-tiered risk-based average MME/day thresholds: low (>0 to <50), medium (≥50 to <90), and high (≥90). Multinomial logistic regression was used to estimate the association of state-level policies with the thresholds while adjusting for relevant patient-specific factors.<BR><B>RESULTS: </B>NCOUs in states with medium or high PDMP robustness had lower odds of receiving medium (adjusted odds ratio [AOR] 0.74; 95 percent confidence interval [CI]: 0.62-0.69) and high (AOR 0.74; 95 percent CI: 0.59-0.92) thresholds. With respect to cannabis policies, NCOUs in states with medical cannabis dispensaries had lower odds of receiving high (AOR 0.75; 95 percent CI: 0.60-0.93) thresholds, while cannabis decriminalization had higher odds of receiving high (AOR 1.24; 95 percent CI: 1.04-1.49) thresholds.<BR><B>CONCLUSIONS: </B>States with highly robust PDMPs and medical cannabis dispensaries had lower odds of receiving higher opioid thresholds, while cannabis decriminalization correlated with higher odds of receiving high opioid thresholds.