{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T13:05:41Z","timestamp":1789218341906,"version":"build-2803163510"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many U.S. states have enacted opioid-limiting laws to curb the opioid epidemic, often capping opioid prescriptions at seven days. How these laws affect opioid prescribing among long-term survivors of childhood cancer remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using Medicaid claims linked to the Childhood Cancer Survivor Study, we identified childhood cancer survivors aged 18-64 years continuously enrolled in Medicaid \u22651 year during 2009-2019. Primary outcomes were any opioid prescription fill and opioid prescription with &amp;gt;7 days\u2019 supply. Secondary outcomes included total number of opioid prescriptions, total days of supply, and mean morphine milligram equivalents per supply day. Difference-in-differences models assessed associations between opioid-limiting law implementation and outcomes, adjusting for sociodemographic and clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 2,351 survivors (57.0% female, 43.9% aged 18\u201329 years, 10.2% non-Hispanic Black, 9.7% Hispanic), with 15,323 person-years. Overall, 20.5% filled any opioid prescription, and 9.4% filled prescriptions with &amp;gt;7 days\u2019 supply. Opioid-limiting laws were associated with 1.77 percentage points (ppt; p=0.047) reduced likelihood of filling any opioid prescription with &amp;gt;7 days\u2019 supply. Associations with other outcomes were not statistically significant. In subgroup analyses, survivors with second cancer experienced statistically significant declines in any opioid prescriptions (-6.96 ppt, p=0.034), prescriptions with &amp;gt;7 days\u2019 supply (-7.79 ppts, p=0.001), total number of prescriptions (-0.42, p=0.019), and total days of supply (-7.40 days, p=0.003) following law implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While opioid-limiting laws were not associated with meaningful reductions in opioid prescribing among Medicaid-enrolled adult survivors of childhood cancer overall, notable declines were observed among subgroups with potentially higher pain care needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag326","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T11:46:04Z","timestamp":1789213564000},"source":"Crossref","is-referenced-by-count":0,"title":["Opioid limiting law and opioid prescriptions among Medicaid-enrolled survivors of childhood cancer"],"prefix":"10.1093","author":[{"given":"Xin","family":"Hu","sequence":"first","affiliation":[{"name":"Emory University School of Medicine Department of Radiation Oncology, , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L","family":"Klosky","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Department of Pediatrics, , Atlanta, GA,","place":["USA"]},{"name":"Children\u2019s Healthcare of Atlanta Aflac Cancer & Blood Disorders Center, , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deo Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital Department of Biostatistics, , Memphis, TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanji","family":"Zhang","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Department of Radiation Oncology, , Atlanta, GA,","place":["USA"]},{"name":"Emory University School of Medicine Department of Pediatrics, , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara M","family":"Brinkman","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital Department of Epidemiology and Cancer Control, , Memphis, TN,","place":["USA"]},{"name":"St. Jude Children's Research Hospital Department of Psychology and Biobehavioral Sciences, , Memphis, TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Krull","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital Department of Psychology and Biobehavioral Sciences, , Memphis, TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C","family":"Nathan","sequence":"additional","affiliation":[{"name":"University of Toronto Division of Hematology\/Oncology, Department of Pediatrics, The Hospital for Sick Children and , Toronto, ON,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Snyder","sequence":"additional","affiliation":[{"name":"Bloomberg School of Public Health Departments of Medicine, Oncology, and Health Policy & Management, Johns Hopkins University School of Medicine and , Baltimore, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory T","family":"Armstrong","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital Department of Epidemiology and Cancer Control, , Memphis, TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikki","family":"Nolan","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital Department of Epidemiology and Cancer Control, , Memphis, TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Yasui","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital Department of Biostatistics, , Memphis, TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M","family":"Castellino","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Department of Pediatrics, , Atlanta, GA,","place":["USA"]},{"name":"Children\u2019s Healthcare of Atlanta Aflac Cancer & Blood Disorders Center, , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Ji","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Department of Pediatrics, , Atlanta, GA,","place":["USA"]},{"name":"Children\u2019s Healthcare of Atlanta Aflac Cancer & Blood Disorders Center, , Atlanta, GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,12]]},"container-title":["JNCI: Journal of the National Cancer Institute"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article-pdf\/doi\/10.1093\/jnci\/djag326\/71046439\/djag326.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article-pdf\/doi\/10.1093\/jnci\/djag326\/71046439\/djag326.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T12:12:06Z","timestamp":1789215126000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jnci\/advance-article\/doi\/10.1093\/jnci\/djag326\/8792922"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,12]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/jnci\/djag326","relation":{},"ISSN":["0027-8874","1460-2105"],"issn-type":[{"value":"0027-8874","type":"print"},{"value":"1460-2105","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,12]]},"article-number":"djag326"}}