Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 16;18(11):e0294279.
doi: 10.1371/journal.pone.0294279. eCollection 2023.

Impact of opioid law on prescriptions and satisfaction of pediatric burn and orthopedic patients: An epidemiologic study

Megan Armstrong  1   2 , Jonathan I Groner  1   2   3   4 , Julie Samora  4   5 , Vanessa A Olbrecht  4   6 , Nguyen K Tram  6 , Dana Noffsinger  1   3 , Edward W Boyer  7 , Henry Xiang  1   2   4
Affiliations

Impact of opioid law on prescriptions and satisfaction of pediatric burn and orthopedic patients: An epidemiologic study

Megan Armstrong et al. PLoS One. .

Abstract

Objectives: The objective of this study was to determine the reduction in prescribed opioid pain dosage units to pediatric patients experiencing acute pain and to assess patient satisfaction with pain control 90-day post discharge following the 2017 Ohio opioid prescribing cap law.

Methods: The retrospective chart review included 960 pediatric (age 0-18 years) burn injury and knee arthroscopy patients treated between August 1, 2015-August 31, 2019. Prospectively, legal guardians completed a survey for a convenience sample of 50 patients. Opioid medications (days and morphine milligram equivalents (MMEs)/kg) prescribed at discharge before and after the Ohio law implementation were collected. Guardians reported experience and satisfaction with their child's opioid prescription at 90-days post discharge.

Results: From pre-law to post-law, there was a significant decrease (p<0.001) within the burn and knee cohorts in the median days (1.7 to 1.0 and 5.0 to 3.8, respectively) and median total MMEs prescribed (15.0 to 2.5 and 150.0 to 90.0, respectively). An interrupted time series analysis revealed a statistically significant decrease in MMEs/kg and days prescribed at discharge when the 2017 Ohio opioid prescription law went into effect, with an abrupt level change. Prospectively, more than half of participants were satisfied (72% burn and 68% knee) with their pain control and felt they received the right amount of medication (84% burn and 56% knee). Inpatient opioid use was not changed pre- and post-law.

Conclusions: Discharge opioids prescribed for pediatric burn and knee arthroscopy procedures has decreased from 2015-2019. Caregivers varied greatly in their satisfaction with pain control and the amount of opioid prescribed.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. CONSORT diagram for prospective survey recruitment.
Fig 2
Fig 2
A & B: Median MME/kg and days prescribed at discharge for combined burn injury and knee arthroscopy, pre- and post-law.
Fig 3
Fig 3. Number of days and MMEs/kg prescribed at discharge by days to law change.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Miech R, Johnston L, O’Malley PM, Keyes KM, Heard K. Prescription Opioids in Adolescence and Future Opioid Misuse. Pediatrics. 2015;136(5):e1169–77. doi: 10.1542/peds.2015-1364 - DOI - PMC - PubMed
    1. Chua KP, Brummett CM, Conti RM, Bohnert AS. Opioid Prescribing to US Children and Young Adults in 2019. Pediatrics. 2021;148(3). doi: 10.1542/peds.2021-051539 - DOI - PMC - PubMed
    1. National Center for Health Statistics. Drug Overdose Mortality by State: Centers for Disease Control and Prevention; 2022. [Available from: https://www.cdc.gov/nchs/pressroom/sosmap/drug_poisoning_mortality/drug_....
    1. Ciccarone D. The triple wave epidemic: Supply and demand drivers of the US opioid overdose crisis. Int J Drug Policy. 2019;71:183–8. doi: 10.1016/j.drugpo.2019.01.010 - DOI - PMC - PubMed
    1. Jalal H, Buchanich JM, Sinclair DR, Roberts MS, Burke DS. Age and generational patterns of overdose death risk from opioids and other drugs. Nat Med. 2020;26(5):699–704. doi: 10.1038/s41591-020-0855-y - DOI - PMC - PubMed

Substances