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Is Opioid-Limiting Legislation Effective for Hand Surgery Patients?
Kalpit N Shah1, Daniel B C Reid1, Jack H Ruddell1
1Brown University, Providence, RI, USA.
Hand (New York, N.Y.)
|February 3, 2021
Summary
Rhode Island
Area of Science:
- Orthopedics
- Pain Management
- Public Health Policy
Background:
- Rhode Island enacted the Uniform Controlled Substances Act in 2016 to curb opioid prescriptions.
- Opioid prescribing patterns in hand surgery patients require objective evaluation.
Purpose of the Study:
- To assess the impact of the 2016 Uniform Controlled Substances Act on opioid prescribing for hand surgery.
- To identify predictors of extended opioid use in this patient cohort.
Main Methods:
- A comparative analysis of opioid prescriptions before (Jan-Jun 2016) and after (Jul-Dec 2017) the law's implementation.
- Categorization of hand surgeries into "major" (e.g., arthroplasty, fracture fixation) and "minor" (e.g., carpal tunnel release).
- Utilization of the Prescription Drug Monitoring Database to track controlled substance dispensations.
Main Results:
- A significant reduction in initial opioid prescription quantity and morphine milligram equivalents (MMEs) for major hand surgeries post-legislation.
- A 30% decrease in 30-day postoperative MMEs for major hand surgery patients.
- Male sex and prior opioid use emerged as risk factors for prolonged opioid use.
Conclusions:
- The opioid-limiting legislation in Rhode Island effectively reduced initial opioid prescriptions and 30-day MMEs for major hand surgery.
- Further investigation is warranted to correlate legislative impact with patient clinical outcomes.
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