In 2017, the Department of Health and Human Service declared a public health emergency known as the opioid crisis. In North Carolina, the "Strengthen Opioid Misuse Prevention Act of 2017" (STOP Act) went into effect on January 1, 2018, seeking to strengthen oversight over opioid prescriptions. Among other mandates, this legislation limited the duration of the initial prescription to 5 or 7 days. The purpose of this study was to compare narcotic prescription practices within the Department of Orthopaedic Surgery at an academic medical center before and after the enactment of the STOP Act. We hypothesized that there would be a statistically significant decrease in the amount of postoperative opioids prescribed after the STOP Act and that this decrease would be consistent across all types of providers in the Orthopaedic Surgery Department.
Methods: Opiate prescriptions data from all orthopaedic surgery providers at our academic institution were collected from January to the end of September in 2017 and from January to the end of September in 2018. After filtering the providers by our study's inclusion and exclusion criteria, we included data from 49 providers in our analysis. We used a paired t-test to compare the prescription data between the two periods.
Results: There was a 35% decrease in morphine milligram equivalents prescribed at our institution between 2017 and 2018 (P = 0.0003). This reduction was statistically significant and equaled 27,374 less morphine milligram equivalents prescribed per provider (95% confidence interval 13,226 to 41,523). The average number of opiate prescriptions per provider decreased from 171.5 in 2017 to 161 in 2018 (P = 0.48), although this was not statistically significant.
Conclusion: The STOP Act effectively decreased the amount of opiates prescribed within our Orthopaedic Surgery Department. Similar legislation may be effective in other states and at the federal level to decrease narcotic prescriptions and subsequent abuse.
Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.