State policies that curb the abuse of opioid prescription painkillers such as OxyContin and Vicodin may be having some unintended side effects and hurting those who need the medications the most.
Researchers in the UGA School of Public and International Affairs are using a $150,000 grant from the Robert Wood Johnson Foundation to evaluate whether prescription drug monitoring programs in place in most states are keeping patients who need opioids from receiving them. The grant program, through the foundation’s Public Health Law Research program, is designed to provide funding for studies that analyze or evaluate laws and their effect on public health.
“With prescription drug monitoring programs covering nearly every state, they have the potential to have a widespread effect on people’s access to important therapies for pain, yet no one has analyzed the relationship between the monitoring programs and pain management,” said Courtney Yarbrough, a second-year doctoral student in the public administration and policy department. “The grant gives us the opportunity to explore the implications of these laws in detail and to provide objective information to policymakers and states as they continue to update their programs.”
Yarbrough and W. David Bradford, the George D. Busbee Professor in Public Policy in the public administration and policy department, are collaborators on the grant.
“Opioids fall under the Controlled Substances Act because of their potential to be addictive, and they can be very dangerous if taken inappropriately,” Bradford said. “Opioids have become a major public health concern in recent years. Between 1999 and 2010, sales of opioid analgesics increased by more than 300 percent, and opioid overdose deaths rose 265 percent for men and 415 percent for women.”
Most states have responded to the epidemic by implementing prescription drug monitoring programs, an electronic registry where doctors and pharmacists must report opioid prescriptions written and dispensed. The purpose of the programs is to monitor behavior and detect either inappropriate use by patients or inappropriate prescribing or dispensing by health care providers.
For many patients, opioids are the only feasible treatments for their pain. Prescription drug monitoring programs might have an adverse effect on pain management if they restrict access to drugs for people who need them by creating stigmas surrounding the drugs, discouraging doctors from prescribing them or making them more costly to obtain, Bradford said.
Bradford and Yarbrough’s study will use data from the Medicare Current Beneficiary Survey, which tracks Medicare patients over time to examine changes in patients’ pain outcomes before and after prescription drug monitoring programs are implemented in their states. With this very rich data, the effects of the monitoring programs will be analyzed on a variety of patients-such as nursing home, hospice or cancer patients-who might be particularly vulnerable to changes in opioid access.
The study also will explore the differential effects of some state-to-state variations in monitoring programs.