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New legislation in New Jersey reduced opioid use among trauma patients

Renay Durling-Grover, DNP, APN, Louis T. DiFazio, MD, FACS, John M. Adams, MD, FACS, Karen Kong, BS, Sara S. Soliman, BS, Daniel Hakakian, BS, Keren Kaynan, BS, Rolando H. Rolandelli, MD, FACS, Zoltan H. Nemeth, MD, PhD


Purpose: In New Jersey, politicians have emphasized the need to attenuate the ongoing opioid epidemic as opioid use disorder can lead to addiction and, in many cases, mortality. New legislation (New Jersey Senate Bill 3) was enacted in 2017 to reduce opioid prescription from 30 days to 5 days for acute pain in both inpatient and outpatient healthcare settings. Therefore, we sought to evaluate if the enactment of the bill influenced the consumption of opioid pain medication at an American College of Surgeons-verified Level I Trauma Center.

Methods: Patients from 2016 to 2018 were compared for differences in average daily inpatient morphine milligram equivalents (MMEs) consumption and injury severity score (ISS), among other parameters. To ensure that changes in pain medication did not affect the quality of pain management, we compared their average pain ratings.

Results: Although the average ISS in 2018 was higher than that in 2016 (10.6 ± 0.2 vs 9.1 ± 0.2, p < 0.001), opioid consumption decreased in 2018 without increasing the average pain rating for patients with an ISS of 9 and 10. More specifically, the average daily inpatient MMEs consumption dropped from 14.1 ± 0.5 in 2016 to 8.8 ± 0.3 in 2018 (p < 0.001). Even among patients with an average ISS >15, the total MMEs consumed per person decreased in 2018 (116.0 ± 14.0 vs 59.4 ± 7.6, p < 0.001).

Conclusion: Overall, opioid consumption was lower in 2018 without negatively affecting the quality of pain management. This suggests that the implementation of the new legislation has successfully reduced inpatient opioid use.


opioid; trauma; deaths; laws; prescribing; consumption

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