Effect of CURES Legislation on Narcotic Prescriptions After Soft-tissue Hand Surgery

Area of Science:

• Orthopaedic Surgery
• Pain Management
• Public Health Policy

Background:

• California's Controlled Substance Utilization Review and Evaluation System (CURES) was enacted in 2018 to curb opioid prescriptions.
• Opioid use after soft tissue hand surgery requires careful monitoring due to potential for misuse.

Purpose of the Study:

• To assess the impact of CURES legislation on postoperative opioid prescriptions for patients undergoing soft tissue hand surgery.
• To quantify changes in opioid dosage and frequency post-implementation of CURES.

Main Methods:

• Retrospective cohort study comparing patients before and after CURES implementation.
• Included patients undergoing carpal tunnel release, trigger finger release, and ganglion excisions.
• Primary outcome measured was milligram morphine equivalent (MME) prescribed postoperatively and at first follow-up.

Main Results:

• The post-CURES cohort showed a significant reduction in MME prescribed compared to the pre-CURES cohort.
• Average MME prescribed postoperatively decreased from 116.9 to 58.8.
• Average MME at first follow-up decreased from 10.2 to 1.1.

Conclusions:

• California's CURES legislation appears effective in reducing opioid prescribing for soft tissue hand surgery.
• State regulations may play a significant role in mitigating postoperative narcotic consumption.
• Further research can explore long-term effects and patient outcomes.