TY - JOUR
T1 - Impact of Michigan's new opioid prescribing laws on spine surgery patients
T2 - Analysis of the Michigan spine surgery improvement collaborative
AU - Park, Paul
AU - Chang, Victor
AU - Yeh, Hsueh Han
AU - Schwalb, Jason M.
AU - Nerenz, David R.
AU - Schultz, Lonni R.
AU - Abdulhak, Muwaffak M.
AU - Easton, Richard
AU - Perez-Cruet, Miguelangelo
AU - Kashlan, Osama N.
AU - Oppenlander, Mark E.
AU - Szerlip, Nicholas J.
AU - Swong, Kevin N.
AU - Aleem, Ilyas S.
N1 - Publisher Copyright:
© 2021 AANS.
PY - 2021/3
Y1 - 2021/3
N2 - Objective: In 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery. Methods: Patient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated. Results: Patients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323). Conclusions: There was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.
AB - Objective: In 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery. Methods: Patient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated. Results: Patients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323). Conclusions: There was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.
KW - Drug addiction
KW - Narcotics
KW - Opioids
KW - Pain relief
KW - Patient-reported outcomes
KW - Spinal surgery
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U2 - 10.3171/2020.7.SPINE20729
DO - 10.3171/2020.7.SPINE20729
M3 - Article
C2 - 33307531
AN - SCOPUS:85102173943
VL - 34
SP - 531
EP - 536
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
SN - 1547-5654
IS - 3
ER -