Abstract

Purpose: In response to the COVID-19 pandemic, the US DEA allowed controlled substance prescriptions to be issued following a telemedicine encounter. This study evaluated changes in opioid prescribing in Kentucky counties with low and high rates of broadband subscription before, during, and after a series of statewide emergency declarations that may have affected health care access. Methods: The study used the prescription drug monitoring program to analyze records of opioid analgesic prescriptions dispensed to opioid-naïve individuals in high (N = 26) and low (N = 94) broadband access counties during 3 periods: before a state of emergency (SOE) and executive order (EO) limiting nonemergent health care services (January 2019-February 2020), while the EO was active (March-April 2020), and after health care services began reopening (May-December 2020). Marginal generalized estimating equations-type negative binomial models were fit to compare prescription counts by broadband access over the 3 periods. Findings: Rates of opioid dispensing to opioid-naïve individuals decreased significantly during the EO, but increased nearly to pre-SOE levels after health care services began reopening. Dispensing rates in low broadband counties were higher than those in high broadband counties during all time periods, although these differences were negligible after adjusting for potential confounders. During the EO, prescriptions were written for longer days’ supply in both county types. Conclusions: The overall dramatic reduction in opioid prescribing rates should be considered when evaluating annual opioid prescribing trends. However, broadband subscription rate did not appear to influence opioid prescriptions dispensed in Kentucky during the EO.

Original languageEnglish
Pages (from-to)900-907
Number of pages8
JournalJournal of Rural Health
Volume38
Issue number4
DOIs
StatePublished - Sep 1 2022

Bibliographical note

Funding Information:
This research was supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration through the NIH HEAL Initiative under award numbers UM1DA049394, UM1DA049406, UM1DA049412, UM1DA049415, and UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939). This study protocol (Pro00038088) was approved by Advarra Inc., the HEALing Communities Study single Institutional Review Board. We wish to acknowledge the participation of the HEALing Communities Study communities, community coalitions, and Community Advisory Boards and state government officials who partnered with us on this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, or the NIH HEAL Initiative.

Funding Information:
This research was supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration through the NIH HEAL Initiative under award numbers UM1DA049394, UM1DA049406, UM1DA049412, UM1DA049415, and UM1DA049417 ( ClinicalTrials.gov Identifier: NCT04111939). This study protocol (Pro00038088) was approved by Advarra Inc., the HEALing Communities Study single Institutional Review Board. We wish to acknowledge the participation of the HEALing Communities Study communities, community coalitions, and Community Advisory Boards and state government officials who partnered with us on this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, or the NIH HEAL Initiative.

Funding Information:
Additionally, we acknowledge the support from the Kentucky All Schedule Prescription Electronic Reporting (KASPER) program, Office of Inspector General, Kentucky Cabinet for Health and Family Services.

Publisher Copyright:
© 2022 National Rural Health Association.

Keywords

  • COVID-19
  • opioid
  • telemedicine

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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