# An Evaluation of State Laws Intended to Curb High-Risk Opioid Prescribing

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $368,381

## Abstract

An Evaluation of State Laws Intended to Curb High-Risk Opioid Prescribing
Opioid overdose deaths continue to increase in the U.S., with over 30,000 deaths in 2015. This epidemic is
driven in large part by the high volume of opioids prescribed by healthcare providers. States have begun to
enact laws designed to curb certain high-risk opioid prescribing practices, such as high-dose prescribing and
overlapping opioid and benzodiazepine prescriptions, which are associated with misuse and mortality. Most
recently, state efforts have centered on four types of laws. First, mandatory prescription drug monitoring
program (PDMP) enrollment laws. While they exist in 49 states, only 35% of controlled substance prescribers
report enrolling with PDMPs, or databases of controlled substance prescriptions that healthcare providers can
access to learn about patients’ past and current prescription drug use. To increase PDMP use, 20 states have
enacted mandatory PDMP enrollment laws, which require prescribers to enroll in – and thereby gain access to
– their state’s PDMP. Second, mandatory PDMP query laws, which require providers to check the PDMP prior
to prescribing opioids, have been enacted in 20 states. Third, pill mill laws, which strictly regulate pain clinics to
prevent rogue clinics from issuing opioid prescriptions without medical indication, have been enacted in 11
states. Fourth, opioid prescribing cap laws, which limit days’ supply and/or dose of prescribed opioids, have
been enacted in seven states. The effects of these laws on high-risk opioid prescribing are largely unknown.
 Using qualitative interviews and Quintiles LifeLink LRx/Dx prescription and outpatient claims
data we propose a mixed methods study of how these four types of laws independently affect high-risk
opioid prescribing. We will focus on 18 “treatment states” that enacted one of the four types of laws of
interest – but no other laws designed to curb high-risk opioid prescribing – over a four-year period. We propose
to: 1) explore the implementation and enforcement of the four types of laws in each of the 18 treatment states;
2) study the independent effects of these four types of state laws on high-risk opioid prescribing patterns; and
3) study the independent effects of the four types of laws on substitution of non-opioid pain treatments among
individuals diagnosed with non-cancer chronic pain. For Aims 2 and 3 we will conduct synthetic control
analyses comparing pre/post law trends in opioid prescribing in each treatment state to trends in a weighted
combination of comparison states. A key strength of the proposed study is our ability to disentangle the causal
effects of each of the four types of laws of interest on high-risk opioid prescribing. The mixed methods
approach is another significant contribution: the results of our Aim 1 interviews will directly inform the design
and interpretation of Aims 2 and 3. In the face of continuing increases in opioid overdose deaths and limited...

## Key facts

- **NIH application ID:** 9968222
- **Project number:** 5R01DA044987-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Emma Elizabeth McGinty
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $368,381
- **Award type:** 5
- **Project period:** 2017-09-30 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9968222

## Citation

> US National Institutes of Health, RePORTER application 9968222, An Evaluation of State Laws Intended to Curb High-Risk Opioid Prescribing (5R01DA044987-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9968222. Licensed CC0.

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