Introduction
The opioid epidemic has been a persistent public health crisis in the United States, contributing to significant morbidity and mortality. In an effort to curb opioid misuse, Florida implemented House Bill 21 (HB21) on July 1, 2018, which limits opioid prescriptions to a 3-day supply for acute pain, or up to 7 days if an exception is documented. A recent study published in the North American Spine Society Journal evaluates the effects of HB21 on opioid prescribing patterns following spine surgery.
Research Findings
The study analyzed data from 378 patients who underwent spine surgery between January 2017 and January 2021. The researchers compared opioid prescribing patterns before and after the implementation of HB21. Key findings from the study include:
- A significant reduction in the average number of morphine milligram equivalents (MMEs) prescribed post-surgery, from 941.2 to 432.5.
- A decrease in the average number of pills prescribed in the first postoperative prescription, from 50.0 to 44.97.
- A reduction in the number of days covered by the first postoperative prescription, from 17.9 to 6.4 days.
These results suggest that HB21 successfully reduced the amount of opioids prescribed following spine surgery, although the need for additional prescriptions within 30 to 90 days post-surgery was noted.
Implications for Practice
The findings from this study highlight the effectiveness of legislative measures in reducing opioid prescriptions. However, the study also emphasizes the need for complementary strategies to manage postoperative pain effectively. Practitioners can enhance their practice by:
- Implementing multimodal pain management strategies that include non-opioid analgesics and nerve blocks.
- Engaging in thorough preoperative patient education to set realistic expectations for pain management.
- Participating in opioid stewardship programs to ensure responsible prescribing practices.
- Utilizing prescription drug monitoring programs to track and manage opioid prescriptions effectively.
Encouraging Further Research
While the study provides valuable insights, it also underscores the need for further research. Future studies should involve a larger patient cohort across multiple institutions to validate the findings and explore the long-term impact of HB21 on opioid consumption. Additionally, research into the effectiveness of various multimodal pain management regimens could provide practitioners with evidence-based strategies to minimize opioid use while effectively managing postoperative pain.
To read the original research paper, please follow this link: The impact of the Florida law HB21 on opioid prescribing patterns after spine surgery.
