Opioid Regulation Laws Show No Impact on Disabled Worker Population

Disabled workers have a higher rate of overdose-related death.

State opioid abuse laws were found to have no impact on disabled workers who face a greater risk for overdose.

There were 81 laws created to restrict prescribing and dispensing of prescription opioids after a fourfold increase in deaths between 2006 to 2012, according to a study published in the New England Journal of Medicine.

“States hoped passing a range of laws might help. So they are enacting small fixes, forbidding patients from ‘doctor-shopping,’ and requiring doctors to use tamper-resistant prescription forms,” said researcher Jill Horowitz, PhD, JD. “They are also implementing major efforts such as prescription drug monitoring programs (PDMPs), online databases that allow law enforcement and clinicians to monitor prescriptions.”

In the study, researchers analyzed Medicare data from disabled beneficiaries who were 21- to 64-years-old.

"We studied a particularly vulnerable population, disabled Medicare beneficiaries. They have higher rates of opioid use, poverty and complex medical conditions compared to the general U.S. population," said study lead author Ellen Meara, PhD. "Because of their high rate of death from prescription opioid overdose, they could have benefited from effective regulation."

Investigators discovered there were no associations between state laws and dangerous prescribing patterns, such as high daily doses and rate of nonfatal overdose. Researchers found that in 2008, death rates from prescription opioid overdose in the disabled Medicare population were approximately 10 times the national rate.

Since 2012, 20 states have required prescribers to consult with the PDMP prior to prescribing opioids to a new patient, the researchers noted.

"Successful prescription opioid regulation should strike the hard balance between controlling misuse and fostering compassionate pain management. Clinicians need to carefully consider their role in prescription opioid misuse and overdose," said senior author Nancy Morden, MD. "Opioid abuse is a growing threat to public health; prescription drug monitoring programs and other laws are costly. Our findings indicate they don't do much to curb opioid abuse or overdose, at least in this vulnerable population. States might invest more resources in evaluating the effectiveness of legislation."