Measuring and Combating Prescription Opioid Use and Abuse in Medicare

衡量和打击医疗保险中处方阿片类药物的使用和滥用

• 批准号: 9003485
• 负责人: Sarah Axeen
• 金额: $ 2.68万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9003485
• 关键词: Measuring; Combating; Prescription; Opioid; Use; Measuring; Combating; Prescription; Opioid; Use

 DESCRIPTION (provided by applicant): Abstract Abuse of legal prescription drugs, particularly opioids, is a growing problem in the United States. The abuse leads to addiction, negative health outcomes, increased disability costs, and death caused by overdose or poisoning. Sales of prescription opioids and the negative health outcomes related to opioid use grew rapidly over the past decade. Overdoses, reports of abuse, and enrollment in drug treatment programs for prescription drugs are larger than for illicit drugs. In 2007, opioid overdoses became the second leading cause of unintentional death. Estimates place the total societal costs of this abuse at nearly $56 billion. Recent research has shown that the problem of licit drug abuse extends to the Medicare population where there are many documented cases of fraudulent utilization of opioids. The White House branded this increase in prescription drug abuse a public health and safety crisis. In response, states are experimenting with various solutions to this growing epidemic. Anecdotal evidence has shown positive results for some of these laws, but there is no systematic analysis of the impact of those efforts on opioid use and abuse. A key impediment to a thorough understanding of the impact of these state laws on opioid use and abuse is a lack of sufficiently detailed, representative data on medical and prescription drug claims. By relying on a 20 percent sample of all Medicare inpatient, outpatient, office, and prescription drug claims, alongside detailed demographic information, this project will assess the extent of opioid use and abuse in the Medicare population and the impact of these state laws in affecting that use and abuse. I will also characterize predictors of opioid use and abuse and describe the time trends in opioid use as well as differences in use by age, race/ethnicity, gender, Medicare eligibility status, and income. I will develop novel indicators of opioid abuse based on administrative claims and validated against medical diagnoses. I will create a state- level database on the type and effective dates of state regulations of prescription drugs. Finally, I will exploit the state-level variation in effective dates to empirically estimatethe causal impact of these laws on measures of opioid use and abuse.

 描述（由适用提供）：在美国，对法律处方药，特别是阿片类药物的抽象滥用是一个日益严重的问题。滥用导致成瘾，负面健康结果，增加的残疾成本以及因过量或中毒而导致的死亡。在过去的十年中，处方阿片类药物的销售和与阿片类药物使用相关的负面健康结果迅速增长。过量服用，滥用的报告和处方药物药物治疗计划的入学率要大于非法药物。 2007年，阿片类药物过量成为无意死亡的第二大主要原因。估计将这种虐待的总成本定为近560亿美元。最近的研究表明，滥用毒品的问题扩展到了医疗保险人群，其中有许多欺诈性利用阿片类药物的案例。白宫为处方药滥用的这种增加的公共卫生和安全危机的烙印。作为回应，各国正在尝试各种解决方案，以解决这种日益增长的流行病。轶事证据对其中一些法律显示了积极的结果，但是对这些努力对阿片类药物使用和滥用的影响没有系统的分析。完全理解这些州法律对阿片类药物使用和滥用的影响的关键障碍是缺乏足够详细的信息，代表了有关医疗和处方药索赔的数据。通过依靠所有医疗保险住院，门诊，办公室和处方药索赔的20％样本以及详细的人口统计信息，该项目将 评估Medicare人群中使用和滥用量和滥用的程度，以及这些州法律在影响使用和滥用方面的影响。我还将表征卵巢剂使用和滥用的预测因素，并描述使用量，种族/种族，性别，医疗保险评估状况和收入的卵巢毒素使用时间趋势以及差异。我将制定新颖的指标 基于行政索赔的OOPIEED滥用，并针对医学诊断进行了验证。我将在州规定的类型和有效日期上创建一个州级数据库 毒品。最后，我将利用有效日期的状态级别差异，以估算这些法律对阿片类药物使用和滥用措施的因果影响。