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. 2016 Feb;106(2):291-7.
doi: 10.2105/AJPH.2015.302953. Epub 2015 Dec 21.

Opioid Overdose Deaths and Florida's Crackdown on Pill Mills

Alene Kennedy-Hendricks  1 , Matthew Richey  1 , Emma E McGinty  1 , Elizabeth A Stuart  1 , Colleen L Barry  1 , Daniel W Webster  1
Affiliations

Opioid Overdose Deaths and Florida's Crackdown on Pill Mills

Alene Kennedy-Hendricks et al. Am J Public Health. 2016 Feb.

Abstract

Objectives: We examined the effect on opioid overdose mortality of Florida state laws and law enforcement operations targeting "pill mills."

Methods: We collected 2003 to 2012 mortality data from the Florida Department of Health and the North Carolina State Center for Health Statistics (the comparison state) to estimate changes in the rates of death from prescription opioid, heroin, or any opioid overdose.

Results: Florida's actions were associated with an estimated 1029 lives saved from prescription opioid overdose over a 34-month period. Estimated reductions in deaths grew over the intervention period, with rates per 100,000 population that were 0.6 lower in 2010, 1.8 lower in 2011, and 3.0 lower in 2012 than what would have been expected had the changes in mortality rate trends in Florida been the same as changes in trends in North Carolina. Florida's mortality rates from heroin and total opioid overdose were also lower than anticipated relative to changes in trends in North Carolina.

Conclusions: Findings from this study indicate that laws regulating pain clinics and enforcement of these laws may, in combination, reduce opioid overdose deaths.

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Figures

FIGURE 1—
FIGURE 1—
Changes in Prescription Opioid Overdose Mortality Rates: Florida and North Carolina, 2003–2012 Note. PDMP = prescription drug monitoring program. The figure overlays the fitted multivariate adaptive regression spline (MARS) model on the observed prescription opioid overdose mortality rates in Florida and North Carolina. Under the counterfactual, we assumed that the rate of change in Florida’s prescription opioid overdose mortality rates would have changed by the same amount that North Carolina’s slope changed at the change point most proximate to the intervention period (January 2010). Note that the year labels indicate the start of each year (January) rather than the midpoint of each year.
FIGURE 2—
FIGURE 2—
Changes in Total Opioid Overdose Mortality Rates: Florida and North Carolina, 2003–2012 Note. PDMP = prescription drug monitoring program. The figure overlays the fitted multivariate adaptive regression spline (MARS) model on the observed total opioid overdose mortality rates in Florida and North Carolina. Under the counterfactual, we assumed that the rate of change in Florida’s prescription opioid overdose mortality rates would have changed by the same amount that North Carolina’s slope changed at the change points during the intervention period (April and November 2010). Note that the year labels indicate the start of each year (January) rather than the midpoint of each year.
FIGURE 3—
FIGURE 3—
Changes in Heroin Overdose Mortality Rates: Florida and North Carolina, 2003–2012 Note. PDMP = prescription drug monitoring program. The figure overlays the fitted multivariate adaptive regression spline (MARS) models for Florida and North Carolina’s heroin overdose mortality rates on the observed data. The MARS models identified 3 change points during the intervention period (March 2010–December 2012): December 2010, August 2011, and December 2011; the latter 2 change points occurred in North Carolina only. Note that the year labels indicate the start of each year (January) rather than the midpoint of each year.
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References

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    1. Santos AG. Combating pharmaceutical diversion: targeting “rogue pain clinics” & “pill mills.”. Prescription Drug Awareness Conference (PDAC), Detroit, MI, 2013. Available at: http://www.deadiversion.usdoj.gov/mtgs/pharm_awareness/conf_2013/may_201.... Accessed July 1, 2014.
    1. Centers for Disease Control and Prevention. Drug overdose deaths—Florida, 2003–2009. MMWR Morb Mortal Wkly Rep. 2011;60(26):869–872. - PubMed
    1. Office of National Drug Control Policy. Fact sheet: prescription drug monitoring programs. 2011. Available at: http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/pdmp_fac.... Accessed January 15, 2015.
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