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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
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The 2017 North Carolina STOP Act is Associated With an Accelerated Decrease in Opioid Dispensing: A Statewide

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North Carolina Medical Journal
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The North Carolina STOP Act correlated with reduced opioid prescriptions and days

Keywords:
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Area of Science:

  • Public Health
  • Pharmacoeconomics
  • Health Policy Research

Background:

  • Opioid prescribing patterns and their impact on public health outcomes.
  • The role of legislative interventions in controlling opioid use.
  • Medicare Part D beneficiaries as a key population for studying prescription drug trends.

Purpose of the Study:

  • To quantify changes in opioid dispensing and days' supply before and after the North Carolina STOP Act.
  • To evaluate the impact of the NC STOP Act on prescribing by physician assistants and nurse practitioners.
  • To assess the association between the NC STOP Act and reductions in opioid prescription days' supply.

Main Methods:

  • Secondary analysis of Medicare Part D Public Use Files (2013-2019).
  • Inclusion of North Carolina providers, select Schedule II (CII), III (CIII) drugs, and tramadol (CV).
  • Utilized multivariable Poisson regression models for data analysis.

Main Results:

  • Population-adjusted claims for included opioids decreased from 180,565.2/100,000 in 2013 to 79,329.12/100,000 in 2019.
  • Multivariable models indicated reductions in per-provider claims and days' supply post-NC STOP Act for CII, CIII, and tramadol.
  • Overall decrease in prescriptions for CII, CIII, and tramadol observed over the study period.

Conclusions:

  • A decreasing trend in opioid dispensations among Medicare beneficiaries was observed since 2013.
  • This trend in opioid use accelerated following the implementation of the NC STOP Act.
  • The study highlights the potential impact of legislative measures on opioid prescribing behaviors.