{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:44:23Z","timestamp":1747226663442,"version":"3.40.5"},"reference-count":61,"publisher":"Weston Medical Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Opioid Management"],"abstract":"<jats:p>Objectives: To evaluate the association of state-level policies on receipt of opioid regimens informed by Centers for Disease Control and Prevention (CDC) morphine milligram equivalent (MME)\/day recommendations.\r\nDesign: A retrospective cohort study of new chronic opioid users (NCOUs).\r\nSetting: Commercially insured plans across the United States using IQVIA PharMetrics\u00ae Plus for Academics database with new chronic use between January 2014 and March 2015.\r\nParticipants: NCOUs with \u226560-day coverage of opioids within a 90-day period with \u226530-day opioid-free period prior to the date of the first qualifying opioid prescription. \r\nInterventions: State-level policies including Prescription Drug Monitoring Program (PDMP) robustness and cannabis policies involving the presence of medical dispensaries and state-wide decriminalization.\r\nMain outcome measures: NCOUs were placed in three-tiered risk-based average MME\/day thresholds: low (&gt;0 to &lt;50), medium (\u226550 to &lt;90), and high (\u226590). Multinomial logistic regression was used to estimate the association of state-level policies with the thresholds while adjusting for relevant patient-specific factors.\r\nResults: NCOUs in states with medium or high PDMP robustness had lower odds of receiving medium (adjusted odds ratio [AOR] 0.74; 95 percent confidence interval [CI]: 0.62-0.69) and high (AOR 0.74; 95 percent CI: 0.59-0.92) thresholds. With respect to cannabis policies, NCOUs in states with medical cannabis dispensaries had lower odds of receiving high (AOR 0.75; 95 percent CI: 0.60-0.93) thresholds, while cannabis decriminalization had higher odds of receiving high (AOR 1.24; 95 percent CI: 1.04-1.49) thresholds.\r\nConclusion: States with highly robust PDMPs and medical cannabis dispensaries had lower odds of receiving higher opioid thresholds, while cannabis decriminalization correlated with higher odds of receiving high opioid thresholds.\r\n\u00a0<\/jats:p>","DOI":"10.5055\/jom.0824","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T10:35:01Z","timestamp":1714646101000},"page":"149-168","source":"Crossref","is-referenced-by-count":0,"title":["State-level policies and receipt of CDC-informed opioid thresholds among commercially insured new chronic opioid users"],"prefix":"10.5055","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4304-396X","authenticated-orcid":false,"given":"Martin J.","family":"Calabrese","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadia T.","family":"Shaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"Palumbo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Lynn","family":"McPherson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ester","family":"Villalonga-Olives","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zafar","family":"Zafari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Mutter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3008","published-online":{"date-parts":[[2024,4,1]]},"reference":[{"key":"90243","doi-asserted-by":"crossref","unstructured":"Dowell D, Haegerich T, Chou R: CDC guideline for prescribing opioids for chronic pain\u2014United States. 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DOI: 10.1002\/pds.3776.","DOI":"10.1002\/pds.3776"},{"key":"90277","doi-asserted-by":"crossref","unstructured":"Peckham AM, Fairman KA, Sclar DA: All-cause and drug-related medical events associated with overuse of gabapentin and\/or opioid medications: A retrospective cohort analysis of a commercially insured US population. Drug Saf. 2018; 41(2): 213-228. DOI: 10.1007\/s40264-017-0595-1.","DOI":"10.1007\/s40264-017-0595-1"},{"key":"90278","doi-asserted-by":"crossref","unstructured":"Eckhardt K, Ammon S, Hofmann U, et al.: Gabapentin enhances the analgesic effect of morphine in healthy volunteers. Anesth Analg. 2000; 91(1): 185-191. DOI: 10.1213\/00000539-200007000-00035.","DOI":"10.1213\/00000539-200007000-00035"},{"key":"90279","doi-asserted-by":"crossref","unstructured":"Corey P, Heck AM, Weathermon RA: Amphetamines to counteract opioid-induced sedation. Ann Pharmacother. 1999; 33(12): 1362-1366. 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DOI: 10.1111\/add.13860.","DOI":"10.1111\/add.13860"},{"key":"90283","doi-asserted-by":"crossref","unstructured":"Hsu G, Kov\u00e1cs B: Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: Panel data study. BMJ. 2021; 372: M4957. DOI: 10.1136\/bmj.m4957.","DOI":"10.1136\/bmj.m4957"},{"key":"90284","doi-asserted-by":"crossref","unstructured":"Bohnert ASB, Guy GP, Losby JL: Opioid prescribing in the United States before and after the centers for disease control and prevention's 2016 opioid guideline. Ann Intern Med. 2018; 169(6): 367-375. DOI: 10.7326\/M18-1243.","DOI":"10.7326\/M18-1243"},{"key":"90285","doi-asserted-by":"crossref","unstructured":"Maust DT, Lin LA, Goldstick JE, et al.: Association of Medicare part D benzodiazepine coverage expansion with changes in fall-related injuries and overdoses among Medicare advantage beneficiaries. JAMA Netw Open. 2020; 3(4): e202051. 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DOI: 10.1097\/j.pain.0000000000001934.","DOI":"10.1097\/j.pain.0000000000001934"},{"key":"90289","doi-asserted-by":"crossref","unstructured":"Edlund MJ, Martin BC, Russo JE, et al.: The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic non-cancer pain: The role of opioid prescription. Clin J Pain. 2014; 30(7): 557-564. DOI: 10.1097\/AJP.0000000000000021.","DOI":"10.1097\/AJP.0000000000000021"},{"key":"90290","doi-asserted-by":"crossref","unstructured":"Shen Y, Bhagwandass H, Branchcomb T, et al.: Chronic opioid therapy: A scoping literature review on evolving clinical and scientific definitions. J Pain. 2021; 22(3): 246-262. DOI: 10.1016\/j.jpain.2020.09.002.","DOI":"10.1016\/j.jpain.2020.09.002"},{"key":"90291","doi-asserted-by":"crossref","unstructured":"Dowell D, Haegerich T, Chou R: CDC guideline for prescribing opioids for chronic pain\u2014United States, 2016. MMWR Recomm Rep. 2016; 65: 1-49. DOI: 10.15585\/mmwr.rr6501e1er.","DOI":"10.15585\/mmwr.rr6501e1er"},{"key":"90292","doi-asserted-by":"crossref","unstructured":"Dowell D: CDC clinical practice guideline for prescribing opioids for pain\u2014United States, 2022. MMWR Recomm Rep. 2022; 71: 1-95. DOI: 10.15585\/mmwr.rr7103a1.","DOI":"10.15585\/mmwr.rr7103a1"},{"key":"90293","unstructured":"Centers for Disease Control and Prevention: Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain. 2018. National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, Atlanta, GA."},{"key":"90294","unstructured":"National Center for Injury Prevention and Control: CDC compilation of benzodiazepines, muscle relaxants, stimulants, zolpidem, and opioid analgesics with oral morphine milligram equivalent conversion factors, 2017 version. 2017. Available at https:\/\/www.cdc.gov\/drugoverdose\/resources\/data.html. Accessed June 21, 2021."},{"key":"90295","doi-asserted-by":"crossref","unstructured":"Chen EH, Shofer FS, Dean AJ, et al.: Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain. Acad Emerg Med. 2008; 15(5): 414-418. DOI: 10.1111\/j.1553-2712.2008.00100.x.","DOI":"10.1111\/j.1553-2712.2008.00100.x"},{"key":"90296","doi-asserted-by":"crossref","unstructured":"Schieber LZ, Guy GP Jr, Seth P, et al.: Trends and patterns of geographic variation in opioid prescribing practices by state, United States, 2006-2017. JAMA Netw Open. 2019; 2(3): e190665-e190665. DOI: 10.1001\/jamanetworkopen.2019.0665.","DOI":"10.1001\/jamanetworkopen.2019.0665"},{"key":"90297","doi-asserted-by":"crossref","unstructured":"Melfi C, Holleman E, Arthur D, et al.: Selecting a patient characteristics index for the prediction of medical outcomes using administrative claims data. J Clin Epidemiol. 1995; 48(7): 917-926. 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DOI: 10.1016\/j.jpain.2012.09.003.","DOI":"10.1016\/j.jpain.2012.09.003"},{"key":"90301","doi-asserted-by":"crossref","unstructured":"Gureje O, Von Korff M, Simon GE, et al.: Persistent pain and well-being: A world health organization study in primary care. JAMA. 1998; 280(2): 147. DOI: 10.1001\/jama.280.2.147.","DOI":"10.1001\/jama.280.2.147"},{"key":"90302","doi-asserted-by":"crossref","unstructured":"Haffajee RL, Mello MM, Zhang F, et al.: Four states with robust Prescription Drug Monitoring Programs reduced opioid dosages. Health Affairs. 2018; 37(6): 964-974. DOI: 10.1377\/hlthaff.2017.1321.","DOI":"10.1377\/hlthaff.2017.1321"},{"key":"90303","doi-asserted-by":"crossref","unstructured":"Haffajee RL, Mello MM, Zhang F, et al.: States with overall robust Prescription Drug Monitoring Programs experienced reductions in opioids prescribed to commercially-insured individuals. Health Aff (Millwood). 2018; 37(6): 964-974. 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