Aspects of opioid regulation and effects on opioid users

Opioid drugs prescribed legally have a great potential for both benefit and harm. The present study examines the potential impact of regulatory changes on opioid prescribing and use as well as differences in opioid use between men and women and among different age groups. The Utah All Payer Claims Database (APCD) includes data that illuminate the effect of proposed changes to opioid prescribing guidelines. The data were analyzed in a cross-sectional study, with a study population of persons who were dispensed opioids in Utah between 2011 and 2013. Between 21% and 44% of prescriptions would likely generate increased demands on provider time and other resources under new guidelines. Women and older Utahns are dispensed disproportionately large numbers of opioids. Men and women receive similar quantities of specific opioids, suggesting providers do not consider the impact of sex on opioid use. Review of the APCD data suggests possible improvements in data quality. In a separate analysis, data from the Utah National Violent Death Reporting System (NVDRS) data were examined in a retrospective cohort study of decedents whose deaths involved prescription opioids. Deaths were analyzed by sex, by age group, and by number of causes of death recorded. iv Women and men displayed different patterns of opioid use. Women were more likely to die after taking drugs that may be considered less potent. Men were more likely to die after taking opioids that were obtained for other persons. Some opioid deaths among older Utahns are probably not recognized as such because death may be attributed to comorbidities. Older opioid decedents are more likely to have committed suicide than younger decedents. Children who die after taking opioids are likely to have taken drugs obtained for other persons, which highlights the importance of drug safety. Opioid patients should be seen within their family and social contexts to promote their health and that of those around them. Sex and age influence opioid use. The data also suggest that promoting effective opioid treatment requires broad perspectives on providers, patients, and patient contexts. Improved health care data quality will strengthen the results of health care research.