{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:50:16Z","timestamp":1788922216914,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005217","name":"National Center for Injury Prevention and Control","doi-asserted-by":"publisher","award":["R01CE003009"],"award-info":[{"award-number":["R01CE003009"]}],"id":[{"id":"10.13039\/100005217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Impact of policies limiting opioid prescribing for acute and post\u2010surgical pain among racially minoritized populations is not well understood. We evaluated the impact of two North Carolina (NC) policies on outpatient opioid prescribing among injury and surgical patients by race, ethnicity, age, and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted controlled and single series interrupted time series using electronic health data from two integrated healthcare systems in NC, among &gt;\u200911\u2009years\u2010old patients having acute injuries and surgery between April 2014 and December 2019. The policy interventions were safe opioid prescribing investigative initiative (SOPI, May 2016) and NC law limiting opioid days' supply (STOP Act, January 2018). Outcomes included, proportion of patients receiving index opioid prescription after surgery or injury event, receipt of subsequent opioid prescriptions, days' supply, and milligrams of morphine equivalents (MME).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 621\u2009997 surgical and 864\u2009061 injury patients, 69.4% and 19.7%, respectively, received an index opioid analgesic prescription. There were sustained declines in index opioid prescription among post\u2010surgical patients after SOPI [\u22122.7% per year (\u22124.6, \u22120.9)] and STOP act [\u22124.1% (\u22125.9, \u22122.2)], but no change among injury patients. Policy\u2010related opioid prescribing declines were larger among black, native American, and Hispanic post\u2010surgical patients than whites and Asians. Index and subsequent opioid days' supply showed sustained declines after SOPI and STOP Act among post\u2010surgical patients. There was no policy impact on MME.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Policies were associated with reductions in opioid prescribing, particularly in post\u2010surgical patients; however, racialized inequities likely reflect implicit and explicit racialized biases in pain management practices.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70144","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T01:09:23Z","timestamp":1745456963000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of State Policies on Opioid Prescribing Among Surgery and Injury Patients: Controlled Interrupted Time\u2010Series Study, North Carolina, 2014\u20132019"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4332-6310","authenticated-orcid":false,"given":"Theo 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabarun","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Injury Prevention Research Center, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney N.","family":"Maierhofer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-4433","authenticated-orcid":false,"given":"Bethany L.","family":"DiPrete","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Injury Prevention Research Center, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryalice","family":"Nocera","sequence":"additional","affiliation":[{"name":"Injury Prevention Research Center, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott K.","family":"Proescholdbell","sequence":"additional","affiliation":[{"name":"Injury and Violence Prevention Branch, Division of Public Health NC Department of Health and Human Services  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Tzy","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences School of Medicine, Duke University  Durham North Carolina USA"},{"name":"Department of Medicine School of Medicine, Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy S.","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"North Carolina Translational and Clinical Sciences Institute, School of Medicine, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Department of Medicine School of Medicine, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Chelminski","sequence":"additional","affiliation":[{"name":"Department of Medicine School of Medicine, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6945-2713","authenticated-orcid":false,"given":"Juan M.","family":"Hincapie\u2010Castillo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health, University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"Injury Prevention Research Center, University of North Carolina at Chapel Hill  Chapel Hill North Carolina 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