Evaluating opioid analgesic prescribing limits: A narrative review

Area of Science:

• Public Health
• Health Policy
• Pharmacology

Background:

• The opioid crisis has led to widespread implementation of opioid analgesic guidelines and prescribing limits.
• These regulations aim to control opioid prescribing and mitigate public health risks.

Purpose of the Study:

• To review evidence on the patient and public health impact of federal and state opioid analgesic prescribing guidelines and laws.
• To identify research gaps and challenges in evaluating these policies.
• To suggest future research directions for assessing policy impacts and unintended consequences.

Main Methods:

• A narrative review of literature published between 2013 and 2019.
• Analysis of 30 studies examining opioid analgesic thresholds and policies, including federal guidelines, state laws, and Medicaid plans.
• Focus on studies evaluating interventions like prior authorization.

Main Results:

• Most studies reported decreases in opioid analgesic prescribing and dispensing following policy implementation.
• Limited research evaluated patient or public health outcomes beyond prescribing patterns.
• Few studies stratified results by sociodemographic or clinical factors, and none assessed potential adverse patient outcomes.

Conclusions:

• Significant knowledge gaps exist regarding the comprehensive impact of opioid analgesic prescribing regulations.
• Further research is needed to adequately assess the effects and unintended consequences of these policies.
• Future studies should focus on patient-centered outcomes and potential harms.