Assessing the Impact of Multiple Levels of Influence on the Use of Hydrocodone Combination Products and Buprenorphine as Opioid Addiction/Dependence Treatment

Millions of Americans suffer from pain, which can be treated with a variety of therapies. Prescription opioid analgesics are among the most widely used treatments for pain. The appropriate use of prescription opioid analgesics can be effective as a part of a pain management strategy. However, a certain degree of risk of abuse, addiction, and dependence is inherently associated with prescription opioid analgesic use. This risk cannot be predicted nor eradicated. Interventions aimed at restricting the use of opioid analgesics have been implemented, the latest of which was rescheduling hydrocodone combination products (HCPs) from schedule III to schedule II (C-II). This federal intervention affected prescribing patterns across all states, though to varying degrees of which are yet to be determined. This study assessed the trends of HCP use over time, comparing the two neighboring states of Texas and Louisiana. These states have different prescribing policies for C-IIs, as well as other differing inherent characteristics influencing prescription opioid analgesic use. These differences were evident with the changes in prescribing trends for HCPs and other types of prescription opioid analgesics. Additionally, this study applied a social ecological model to assess the impact of multiple levels of influence on the treatment of opioid addiction/dependence using buprenorphine. The model showed utility in assessing the impact of the population-level influences at the national, state, and local levels. Interventions targeting a specific level of influence may improve patient care through its subsequent effectiveness.