New Florida law leads to decline in opioid use, according to UF study

A 2018 Florida law restricting opioid prescriptions for acute pain has led to a drop in opioid use, according to a study published by researchers at the University of Florida.

UF researchers found the number of new opioid users per month dropped 16 percent immediately after the law was implemented, and the number of new users continues to decrease each month. Additionally, the average days’ supply fell from 5.4 days prior to the law to three days. The law was also associated with an immediate decrease in the use of hydrocodone, the most commonly used Schedule II opioid.

“The Florida law is among the most restrictive in the country by limiting patients to a three-day opioid supply for acute pain,” said Juan Hincapie-Castillo, Pharm.D., Ph.D., the study’s lead author and an assistant professor of pharmaceutical outcomes and policy in the UF College of Pharmacy, part of UF Health, the University of Florida’s academic health center. “We expected to find a decrease in opioid use following the law, but we did not anticipate the significant decline in the number of users.”

The UF study examined claims data from a private insurer over a four-year period and found the number of opioid users and days’ supply declined after Florida House Bill 21 became law in July 2018. The law limits opioid prescriptions for acute pain to a three-day supply — with certain exceptions — and requires physicians and pharmacists to consult Florida’s state prescription drug monitoring database to review a patient’s prescription history.

“In July 2018, people were walking away with six days’ worth of medications,” said Amie Goodin, Ph.D., a co-author of the study and an assistant professor of pharmaceutical outcomes and policy in the UF College of Pharmacy. “By the end of the study period eight months later, people were walking away with three days’ medications — half the amount of treatment for all the same conditions.”

House Bill 21 only applies to acute pain patients and not chronic pain conditions, such as cancer and trauma. Hincapie-Castillo and Goodin said Florida’s law is not well-defined in terms of diagnosis and confusion still exists among prescribers. More than 30 states have passed opioid restriction laws, with many other states considering similar laws. The research team, which includes Scott M. Vouri, Pharm.D., Ph.D., a clinical assistant professor in the UF College of Pharmacy, have multiple other studies planned or underway looking at the statewide effects of Florida’s opioid restriction law.

“Our goal is to comprehensively evaluate this Florida law, because it does appear to have wide-ranging effects for patients and those working in health care,” Goodin said.

The study, “Changes in Opioid Use After Florida’s Restriction Law for Acute Pain Prescriptions,” was published in the February issue of JAMA Network Open. The publication is an open-access medical journal published by the American Medical Association.

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