News

Overdose deaths drop after Florida cracks down on prescribers

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4425 (Published 03 July 2014) Cite this as: BMJ 2014;349:g4425
  1. Michael McCarthy
  1. 1Seattle

Florida saw a sharp fall in deaths from drug overdose after the state implemented a series of measures to curtail inappropriate prescribing of opioid pain relievers and benzodiazepines, a new report by the US Centers for Disease Control and Prevention has said.1 “These changes,” the researchers wrote, “might represent the first documented substantial decline in drug overdose mortality in any state during the past 10 years.”

From 2003 to 2010 the number of drug overdose deaths in Florida rose by 61%, from 1804 to 2905. During that time, the researchers noted, pain clinics that were prescribing pain relievers with little medical justification proliferated, and by 2010 Florida housed 98 of the 100 US physicians who dispensed the highest quantities of oxycodone directly from their offices.

In response to the epidemic of overdose deaths the state took a series of steps, such as requiring pain clinics that treated pain with controlled substances to join a register, and prohibiting physicians from dispensing schedule 2 drugs (which include meperidine and oxycodone) or schedule 3 drugs (which include combination drugs containing lower doses of hydrocodone and codeine) directly from their offices.

In addition, statewide raids by Florida’s law enforcement led to numerous arrests and the closure of many pain clinics. By 2013 about 250 pain clinics had been closed, and the number of high volume oxycodone dispensing prescribers had fallen from 98 in 2010 to zero in 2013.

With the implementation of these and other measures, the number of deaths from drug overdose fell by 16.7%—from 3201 in 2010 to 2666 in 2012—and the rate fell by 17.7%, the report said. “This change was largely attributable to the decrease in prescription drug related deaths, which peaked at 2722 in 2010 and decreased to 2116 in 2012,” the researchers wrote.

They concluded, “The temporal association between the legislative and enforcement actions and the substantial declines in prescribing and overdose deaths, especially for drugs favored by pain clinics, suggests that the initiatives in Florida reduced prescription drug overdose fatalities.”

Notes

Cite this as: BMJ 2014;349:g4425

References

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