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Evaluating state policy interventions for opioid abuse and diversion: The impact on consumers, healthcare providers, and the U.S. market for prescription opioids.

机译：评估针对阿片类药物滥用和转移的国家政策干预措施：对消费者，医疗保健提供者以及美国处方阿片类药物市场的影响。

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摘要

Prescription opioid pain reliever utilization has been increasing since the 1990s, due in part to changes in recommendations for the treatment of chronic pain, but also to abuse and diversion. One innovative policy solution to the abuse and diversion of prescription opioids is state prescription drug monitoring programs (PDMPs), which provide prescribers and other selected parties with patient controlled substance dispensation history; thereby, correcting an information asymmetry problem between prescribers and patients.;The widespread implementation of state PDMPs, which vary in program design and requirements, has resulted in a variety of intended and unintended consequences. Previous PDMP evaluations have suggested such outcomes as the reduction of consumer access to opioids, the influencing of healthcare provider prescribing behaviors for opioids, and the re-shaping of the United States market for prescription opioids. PDMPs may also be associated with unintended outcomes: namely, the restriction of pharmaceutical opioids could be associated with an increase in heroin use, as evidenced by increases in heroin substance abuse treatment facility discharges. The analyses in this project examine the influence of PDMPs on healthcare providers and the market for prescription drugs by comparing trends in opioid utilization in states with varying PDMP features using Medicaid prescription utilization data and commercial insurance claims. The effect of PDMPs on consumers is explored with an analysis comparing substance abuse treatment facility discharge data for heroin abuse with pharmaceutical opioid prescriptions before and after PDMP regulatory change. Finally, the impact of other related opioid policy interventions, opioid overdose medication access laws, are analyzed by comparing opioid overdose mortality across states with differing overdose medication access policies over time. Contributions to the understanding about the impacts of these state-level opioid abuse and diversion policies can be used to improve or amplify intended outcomes and ameliorate unintended consequences.
机译：自1990年代以来，处方阿片类止痛药的使用一直在增加，部分原因是对治疗慢性疼痛的建议有所变化，但也归因于滥用和转移。国家处方药监测计划（PDMP）是一种针对处方阿片类药物滥用和转移的创新性政策解决方案，该计划可为处方药和其他选定方提供患者控制药物分配的历史记录；状态PDMP的广泛实施，其方案设计和要求各不相同，导致了各种意料之外的后果。先前的PDMP评估提出了这样的结果，例如减少消费者使用阿片类药物的机会，对医疗保健提供者处方阿片类药物的行为的影响以及美国处方阿片类药物市场的重塑。 PDMPs也可能与意想不到的结果有关：即，阿片类药物的限制可能与海洛因的使用增加有关，如海洛因滥用药物治疗设施排放的增加所证明。该项目中的分析通过使用Medicaid处方利用率数据和商业保险索赔比较具有不同PDMP功能的州的阿片类药物使用趋势，从而检验了PDMP对医疗保健提供者和处方药市场的影响。通过比较PDMP法规更改前后的滥用海洛因的药物滥用治疗设施排放数据与阿片类药物处方的分析，探索了PDMP对消费者的影响。最后，通过比较不同时期使用不同药物过量使用政策的州之间的鸦片过量使用死亡率，分析了其他相关的阿片类药物政策干预措施的影响。对这些州级阿片类药物滥用和转移政策的影响的理解的贡献可用于改善或扩大预期的结果并减轻意想不到的后果。

著录项

  • 作者

    Goodin, Amie J.;

  • 作者单位

    University of Kentucky.;

  • 授予单位 University of Kentucky.;
  • 学科 Public policy.;Health care management.
  • 学位 Ph.D.
  • 年度 2015
  • 页码 134 p.
  • 总页数 134
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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