P015: ANALYSIS OF PEDIATRIC OPIATE USAGE AFTER STATE MANDATED OPIOID PRESCRIPTION REGULATIONS IN FLORIDA.
Sydney Shaouy; Haider Ali; University of Central Florida
Introduction: In response to the opioid epidemic, national prescription rates for opiates decreased by 41.4% from 2010 to 2015. Despite this decrease in prescriptions, since 2014-2015, heroin and fentanyl have overtaken both cocaine and prescription related death, likely due to people turning to illicit cheaper drugs, which are commonly adulterated with more powerful opiates such as fentanyl. The pediatric population is not excluded from risks associated with opioid use such as hyperalgesia, tolerance, and withdrawal. on the other had, it is necessary to provide effecitve pain control to those children undergoing major surgery to reduce the sympathetic responses and to increase compliance with post surgical physical therapy. On July 2018, Florida passed the HB 21 Controlled Substances Bill to limit ipiate prescripitons to a 3-7 day supply.
Methods: Retrospective chart review at Nemours Children's Hospital in Orlando, Fl yielded data of 169 patients that had one of the two most painful surgeries in pediatric surgery pectus excavatum repair and spine scoliosis repair. From thos 169 we divided them in 82 patients that had surgery one year before the HB21 bill and 87 patients that had it one year after the bill.
Results: Data analysis reveals that overall, the HB21 Controlled Substances bill significantly reduced the amount of opiate medications prescribed by an average of 86.4 MME. There was also an effect on the law on the number of refills requested from those patient in the arthrodesis surgery group, requesting an average of 0.162 more refills than the pre law group (p= 0.4). There was no significance found on the law refills on the pectus group, which suggest that pain control was adequate on this subgroup, despite the 3-7 day limitation.
Conclusion: HB21 has significantly reduced the number of MME that surgical patients are prescribed at Nemours Children's Hospital for Pectus Excavatum and Scoliosis surgery, which might reduce the potential of opioid abuse or diversion. Some studies have shown that new state prescriptions laws have decrease opiate related death. More long term studies are needed to see if that same relationship is found in the state of Florida on pediatric patients.