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Influence of opioid limiting legislation on patient narcotic usage and provider burden in orthopedic trauma.

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OBJECTIVE Opiate consumption in the United States has reached alarming levels. As a result, the state of Florida enacted House Bill 21 (HB21) in July 2018. Following HB21, we hypothesized… Click to show full abstract

OBJECTIVE Opiate consumption in the United States has reached alarming levels. As a result, the state of Florida enacted House Bill 21 (HB21) in July 2018. Following HB21, we hypothesized total opioids prescribed would decrease, with a resulting increase in phone calls, unscheduled visits for pain control, and refills dispensed. DESIGN Retrospective cohort study comparing opiate usage 6 months before and after HB21 enactment. SETTING Single Level I academic trauma center. PARTICIPANTS Patients with isolated lower extremity fractures who were treated with a single surgery. INTERVENTION Opioid prescription limitations according to Florida's HB21. MAIN OUTCOME MEASURES We compared morphine milligram equivalents (MMEs) dispensed at discharge, length of stay (LOS), readmissions, emergency room (ER) visits, calls for pain control, refills, and total MMEs dispensed for 3 months postoperatively. RESULTS A total of 116 patients met inclusion criteria. Our results demonstrated a decrease in the median MMEs provided at discharge (288 vs. 184, p 0.005) and total MMEs dispensed (375 vs. 225, p 0.0003). There was no significant difference in LOS (2 vs. 2.5 days, p 0.979), unscheduled clinic visits for pain (two per group), ER visits for pain (eight per group), or phone calls for pain (13 vs. 9, p 0.344). There were no readmissions for pain control pre-HB21 and one post-HB21. The percentage of patients obtaining >1 refill decreased from 22.4 to 1.7 percent (p 0.002). CONCLUSIONS Legislation restricting opioid pain medications may be effective in decreasing opiate use in orthopedic trauma patients while decreasing provider burden.

Keywords: orthopedic trauma; visits pain; provider burden; legislation

Journal Title: Journal of opioid management
Year Published: 2022

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