عنوان انگلیسی مقاله:
Implementation and enforcement of state opioid prescribing laws
ترجمه فارسی عنوان مقاله:
پیاده سازی و اجرای قوانین تجویز مواد مخدر دولتی
Sciencedirect - Elsevier - Drug and Alcohol Dependence, 213 (2020) 108107: doi:10:1016/j:drugalcdep:2020:108107
Elizabeth M. Stonea,*, Lainie Rutkowa, Mark C. Bicketb, Colleen L. Barrya, G. Caleb Alexanderc, Emma E. McGintya
Background: In response to the role overprescribing has played in the U.S. opioid crisis, in the past decade states
have enacted four main types of laws to curb opioid prescribing: mandatory prescription drug monitoring
program (PDMP) enrollment laws requiring clinicians to register with a PDMP; mandatory PDMP query laws
requiring clinicians to check a PDMP prior to prescribing opioids; pill mill laws regulating pain management
clinics; and opioid prescribing cap laws limiting the dose/duration of opioid prescriptions. While 47 states now
have one or more of these laws in place, little is known about implementation and enforcement strategies,
facilitators, and barriers.
Methods: From November 2017 to February 2019, we interviewed 114 professionals involved in state opioid
prescribing law implementation and enforcement in 20 states and identified common themes.
Results: Implementation efforts focused on awareness campaigns and targeted training of key front-line implementers.
Enforcement strategies included active, complaint-based, and automated strategies. Collaboration
across agencies and stakeholders, particularly health agencies and law enforcement, was identified as an important
facilitator of implementation and enforcement. Two key interrelated barriers were identified: the
complexity of state opioid prescribing laws in terms of which providers, patients, and prescriptions they applied
to, and IT infrastructure.
Conclusion: Despite differing approaches, our findings suggest similar barriers to implementation and enforcement
across state opioid prescribing laws. Strategies are needed to ease implementation and enforcement of laws
that apply only to specific sub-sets of providers, patients, or prescriptions and address issues of access and data
utilization of the PDMP.
Keywords: Opioid | Policy | Implementation | Enforcement