{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:06:22Z","timestamp":1780099582138,"version":"3.54.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T00:00:00Z","timestamp":1570665600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T00:00:00Z","timestamp":1570665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"published-print":{"date-parts":[[2020,3]]},"DOI":"10.1007\/s11606-019-05302-1","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T17:15:10Z","timestamp":1570727710000},"page":"662-671","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Impact of a State Opioid Prescribing Limit and Electronic Medical Record Alert on Opioid Prescriptions: a Difference-in-Differences Analysis"],"prefix":"10.1007","volume":"35","author":[{"given":"Margaret","family":"Lowenstein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Hossain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Grande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanmarie","family":"Perrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Neuman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ashburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Kit","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,10]]},"reference":[{"issue":"7","key":"5302_CR1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1056\/NEJMsa1610524","volume":"376","author":"ML Barnett","year":"2017","unstructured":"Barnett ML, Olenski AR, Jena AB. Opioid-Prescribing Patterns of Emergency Physicians and Risk of Long-Term Use. The New England journal of medicine. 2017;376(7):663\u2013673.","journal-title":"The New England journal of medicine."},{"issue":"10","key":"5302_CR2","doi-asserted-by":"publisher","first-page":"265","DOI":"10.15585\/mmwr.mm6610a1","volume":"66","author":"A Shah","year":"2017","unstructured":"Shah A, Hayes CJ, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use - United States, 2006-2015. MMWR Morbidity and mortality weekly report. 2017;66(10):265\u2013269.","journal-title":"MMWR Morbidity and mortality weekly report."},{"key":"5302_CR3","doi-asserted-by":"crossref","unstructured":"Shah A, Hayes CJ, Martin BC. Factors Influencing Long-Term Opioid Use Among Opioid Naive Patients: An Examination of Initial Prescription Characteristics and Pain Etiologies. The journal of pain : official journal of the American Pain Society. 2017.","DOI":"10.1016\/j.jpain.2017.06.010"},{"issue":"1","key":"5302_CR4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/s11606-016-3810-3","volume":"32","author":"RA Deyo","year":"2017","unstructured":"Deyo RA, Hallvik SE, Hildebran C, et al. Association Between Initial Opioid Prescribing Patterns and Subsequent Long-Term Use Among Opioid-Naive Patients: A Statewide Retrospective Cohort Study. Journal of general internal medicine. 2017;32(1):21\u201327.","journal-title":"Journal of general internal medicine."},{"issue":"11","key":"5302_CR5","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1001\/jamasurg.2017.0831","volume":"152","author":"MC Bicket","year":"2017","unstructured":"Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL. Prescription Opioid Analgesics Commonly Unused After Surgery: A Systematic Review. JAMA surgery. 2017;152(11):1066\u20131071.","journal-title":"JAMA surgery."},{"issue":"5","key":"5302_CR6","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1001\/jamainternmed.2013.12809","volume":"174","author":"CM Jones","year":"2014","unstructured":"Jones CM, Paulozzi LJ, Mack KA. Sources of prescription opioid pain relievers by frequency of past-year nonmedical use United States, 2008-2011. JAMA internal medicine. 2014;174(5):802\u2013803.","journal-title":"JAMA internal medicine."},{"issue":"5","key":"5302_CR7","doi-asserted-by":"publisher","first-page":"293","DOI":"10.7326\/M17-0865","volume":"167","author":"B Han","year":"2017","unstructured":"Han B, Compton WM, Blanco C, Crane E, Lee J, Jones CM. Prescription Opioid Use, Misuse, and Use Disorders in U.S. Adults: 2015 National Survey on Drug Use and Health. Annals of internal medicine. 2017;167(5):293\u2013301.","journal-title":"Annals of internal medicine."},{"key":"5302_CR8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.addbeh.2017.05.030","volume":"74","author":"TJ Cicero","year":"2017","unstructured":"Cicero TJ, Ellis MS, Kasper ZA. Increased use of heroin as an initiating opioid of abuse. Addictive behaviors. 2017;74:63\u201366.","journal-title":"Addictive behaviors."},{"key":"5302_CR9","doi-asserted-by":"crossref","unstructured":"Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. MMWR Recommendations and reports : Morbidity and mortality weekly report Recommendations and reports. 2016;65(1):1\u201349.","DOI":"10.15585\/mmwr.rr6501e1"},{"key":"5302_CR10","unstructured":"Prescription Drug Abuse Policy System (PDAPS) 2018; \nhttp:\/\/pdaps.org\n\n. Accessed July 8, 2019."},{"key":"5302_CR11","unstructured":"CVS Health Responds to Nation\u2019s Opioid Crisis [press release]. September 21, 2017."},{"key":"5302_CR12","unstructured":"Zezima K. With drug overdoses soaring, states limit the length of painkiller prescriptions. The Washington Post. August 7, 2017."},{"key":"5302_CR13","unstructured":"Independence limits new opioid prescriptions to five days [press release]. June 27 2017."},{"key":"5302_CR14","unstructured":"National Conference of State Legislatures. Prescribing Policies: States Confront Opioid Overdose Epidemic. 2018; \nhttp:\/\/www.ncsl.org\/research\/health\/prescribing-policies-states-confront-opioid-overdose-epidemic.aspx\n\n."},{"issue":"7","key":"5302_CR15","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1001\/jama.2019.0010","volume":"321","author":"KP Chua","year":"2019","unstructured":"Chua KP, Brummett CM, Waljee JF. Opioid Prescribing Limits for Acute Pain: Potential Problems With Design and Implementation. Jama. 2019;321(7):643\u2013644.","journal-title":"Jama."},{"key":"5302_CR16","doi-asserted-by":"crossref","unstructured":"Bohnert ASB, Guy GP, Jr., Losby JL. Opioid Prescribing in the United States Before and After the Centers for Disease Control and Prevention\u2019s 2016 Opioid Guideline. Annals of internal medicine. 2018;169(6):367\u2013375.","DOI":"10.7326\/M18-1243"},{"key":"5302_CR17","doi-asserted-by":"crossref","unstructured":"Mundkur ML, Gordon AJ, Kertesz SG. Will strict limits on opioid prescription duration prevent addiction? advocating for evidence-based policymaking. Substance abuse. 2017:1\u20132.","DOI":"10.1080\/08897077.2017.1345194"},{"issue":"6","key":"5302_CR18","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1056\/NEJMp1803661","volume":"379","author":"M Lowenstein","year":"2018","unstructured":"Lowenstein M, Grande D, Delgado MK. Opioid Prescribing Limits for Acute Pain - Striking the Right Balance. The New England journal of medicine. 2018;379(6):504\u2013506.","journal-title":"The New England journal of medicine."},{"key":"5302_CR19","unstructured":"New Jersey Academy of Family Physicians. NEW PRESCRIBING LAW FOR TREATMENT OF ACUTE AND CHRONIC PAIN. 2017; \nhttps:\/\/www.njafp.org\/content\/new-prescribing-law-treatment-acute-and-chronic-pain\n\n. Accessed July 8, 2019."},{"issue":"4","key":"5302_CR20","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.jcps.2011.06.003","volume":"21","author":"PA Keller","year":"2011","unstructured":"Keller PA, Harlam B, Loewenstein G, Volpp KG. Enhanced active choice: A new method to motivate behavior change. Journal of Consumer Psychology. 2011;21(4):376\u2013383.","journal-title":"Journal of Consumer Psychology."},{"issue":"6","key":"5302_CR21","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/j.genhosppsych.2009.07.003","volume":"31","author":"JB Braden","year":"2009","unstructured":"Braden JB, Sullivan MD, Ray GT, et al. Trends in long-term opioid therapy for noncancer pain among persons with a history of depression. General hospital psychiatry. 2009;31(6):564\u2013570.","journal-title":"General hospital psychiatry."},{"issue":"11","key":"5302_CR22","doi-asserted-by":"publisher","first-page":"2452","DOI":"10.1097\/j.pain.0000000000000650","volume":"157","author":"BT Halbert","year":"2016","unstructured":"Halbert BT, Davis RB, Wee CC. Disproportionate longer-term opioid use among U.S. adults with mood disorders. Pain. 2016;157(11):2452\u20132457.","journal-title":"Pain."},{"issue":"9","key":"5302_CR23","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1001\/jamainternmed.2016.3298","volume":"176","author":"EC Sun","year":"2016","unstructured":"Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and Risk Factors for Chronic Opioid Use Among Opioid-Naive Patients in the Postoperative Period. JAMA internal medicine. 2016;176(9):1286\u20131293.","journal-title":"JAMA internal medicine."},{"key":"5302_CR24","unstructured":"Centers for medicare and Medicaid Services. Opioid Oral Morphine Milligram Equivalent (MME) Conversion Factors. 2017; \nhttps:\/\/www.cms.gov\/Medicare\/Prescription-Drug-Coverage\/PrescriptionDrugCovContra\/Downloads\/Opioid-Morphine-EQ-Conversion-Factors-Aug-2017.pdf\n\n. Accessed July 8, 2019."},{"issue":"10","key":"5302_CR25","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1001\/jamainternmed.2015.3931","volume":"175","author":"L Rutkow","year":"2015","unstructured":"Rutkow L, Chang HY, Daubresse M, Webster DW, Stuart EA, Alexander GC. Effect of Florida\u2019s Prescription Drug Monitoring Program and Pill Mill Laws on Opioid Prescribing and Use. JAMA internal medicine. 2015;175(10):1642\u20131649.","journal-title":"JAMA internal medicine."},{"key":"5302_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.drugalcdep.2016.04.033","volume":"165","author":"HY Chang","year":"2016","unstructured":"Chang HY, Lyapustina T, Rutkow L, et al. Impact of prescription drug monitoring programs and pill mill laws on high-risk opioid prescribers: A comparative interrupted time series analysis. Drug and alcohol dependence. 2016;165:1\u20138.","journal-title":"Drug and alcohol dependence."},{"issue":"5","key":"5302_CR27","doi-asserted-by":"publisher","first-page":"e182908","DOI":"10.1001\/jamanetworkopen.2018.2908","volume":"1","author":"BR Meisenberg","year":"2018","unstructured":"Meisenberg BR, Grover J, Campbell C, Korpon D. Assessment of Opioid Prescribing Practices Before and After Implementation of a Health System Intervention to Reduce Opioid Overprescribing. JAMA network open. 2018;1(5):e182908.","journal-title":"JAMA network open."},{"issue":"2","key":"5302_CR28","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.jamcollsurg.2018.04.032","volume":"227","author":"WH Tan","year":"2018","unstructured":"Tan WH, Yu J, Feaman S, et al. Opioid Medication Use in the Surgical Patient: An Assessment of Prescribing Patterns and Use. J Am Coll Surg. 2018;227(2):203\u2013211.","journal-title":"J Am Coll Surg."},{"key":"5302_CR29","unstructured":"Centers for Disease Control and Prevention. Prescription Opioid Data. 2018; \nhttps:\/\/www.cdc.gov\/drugoverdose\/maps\/rxrate-maps.html\n\n. Accessed July 8, 2019."},{"issue":"22","key":"5302_CR30","doi-asserted-by":"publisher","first-page":"2401","DOI":"10.1001\/jama.2014.16153","volume":"312","author":"JB Dimick","year":"2014","unstructured":"Dimick JB, Ryan AM. Methods for evaluating changes in health care policy: the difference-in-differences approach. Jama. 2014;312(22):2401\u20132402.","journal-title":"Jama."},{"issue":"1","key":"5302_CR31","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1056\/NEJMsa1514387","volume":"375","author":"E Meara","year":"2016","unstructured":"Meara E, Horwitz JR, Powell W, et al. State Legal Restrictions and Prescription-Opioid Use among Disabled Adults. The New England journal of medicine. 2016;375(1):44\u201353.","journal-title":"The New England journal of medicine."},{"issue":"10","key":"5302_CR32","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.2105\/AJPH.2018.304590","volume":"108","author":"AL Pitt","year":"2018","unstructured":"Pitt AL, Humphreys K, Brandeau ML. Modeling Health Benefits and Harms of Public Policy Responses to the US Opioid Epidemic. American journal of public health. 2018;108(10):1394\u20131400.","journal-title":"American journal of public health."},{"key":"5302_CR33","unstructured":"American College of Emergency Physicians. E-QUAL Network Opioid Initiative. 2018; \nhttps:\/\/www.acep.org\/administration\/quality\/equal\/e-qual-opioid-initiative\/\n\n. Accessed July 8, 2019."},{"key":"5302_CR34","unstructured":"Opioid Prescribing Engagement Network. Opioid Prescribing Recommendations for Surgery. 2019; \nhttps:\/\/opioidprescribing.info\/\n\n. Accessed July 9, 2019."},{"key":"5302_CR35","doi-asserted-by":"crossref","unstructured":"Howard R, Fry B, Gunaseelan V, et al. Association of Opioid Prescribing With Opioid Consumption After Surgery in Michigan. JAMA surgery. 2018:e184234.","DOI":"10.1001\/jamasurg.2018.4234"},{"issue":"3","key":"5302_CR36","doi-asserted-by":"publisher","first-page":"e180818","DOI":"10.1001\/jamanetworkopen.2018.0818","volume":"1","author":"MS Patel","year":"2018","unstructured":"Patel MS, Kurtzman GW, Kannan S, et al. Effect of an Automated Patient Dashboard Using Active Choice and Peer Comparison Performance Feedback to Physicians on Statin Prescribing: The PRESCRIBE Cluster Randomized Clinical Trial. JAMA network open. 2018;1(3):e180818.","journal-title":"JAMA network open."},{"issue":"7","key":"5302_CR37","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1007\/s11606-017-4046-6","volume":"32","author":"MS Patel","year":"2017","unstructured":"Patel MS, Volpp KG, Small DS, et al. Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates. Journal of general internal medicine. 2017;32(7):790\u2013795.","journal-title":"Journal of general internal medicine."},{"issue":"4","key":"5302_CR38","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s11606-017-4286-5","volume":"33","author":"MK Delgado","year":"2018","unstructured":"Delgado MK, Shofer FS, Patel MS, et al. Association between Electronic Medical Record Implementation of Default Opioid Prescription Quantities and Prescribing Behavior in Two Emergency Departments. Journal of general internal medicine. 2018;33(4):409\u2013411.","journal-title":"Journal of general internal medicine."},{"issue":"11","key":"5302_CR39","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1001\/jamasurg.2018.2083","volume":"153","author":"AS Chiu","year":"2018","unstructured":"Chiu AS, Jean RA, Hoag JR, Freedman-Weiss M, Healy JM, Pei KY. Association of Lowering Default Pill Counts in Electronic Medical Record Systems With Postoperative Opioid Prescribing. JAMA surgery. 2018;153(11):1012\u20131019.","journal-title":"JAMA surgery."}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-019-05302-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s11606-019-05302-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-019-05302-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T00:29:15Z","timestamp":1602289755000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s11606-019-05302-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,10]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["5302"],"URL":"https:\/\/doi.org\/10.1007\/s11606-019-05302-1","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,10]]},"assertion":[{"value":"27 December 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2019","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2019","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 October 2019","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the University of Pennsylvania Institutional Review Board.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"Dr. Delgado reports receiving an honorarium for participating in an Expert Roundtable on Innovations in Acute Pain Management convened by United Health Group in 2017. He has no current financial conflicts of interest. Dr. Ashburn reported receiving personal fees from the Department of Justice, the Attorney General for the State of Maryland, the Department of State for the Commonwealth of Pennsylvania, the Montgomery County District Attorney, and the Carolinas Pain Society. All remaining authors declare that they do not have a conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}