Thursday, November 8, 2018

Two new legal maps released today on track key laws and other regulatory strategies related to managing access to opioid prescriptions in the United States.

About one-quarter of patients prescribed opioids for chronic pain misuse them, according to the National Institute of Drug Abuse. Many states have sought to address the issue by regulating those medications and access to them, and the health professionals who prescribe them.

“These two datasets are valuable resources as we continue to seek to understand the impact laws may have not only on basic access to prescription drugs, but also the other, broader ripple effects on patients in need of pain management, and ultimately the opioid epidemic,” said Lindsay Cloud, JD, director of the Policy Surveillance Program at the Temple University Center for Public Health Law Research, which published the datasets.

Morphine Equivalent Daily Dose Policies

Research indicates that patients who receive higher doses of prescription opioids have an increased risk of overdose and death. Twenty-two states have enacted 31 Morphine Equivalent Daily Dose (MEDD) policies to combat this risk, according to the data released today.

MEDD thresholds convert opioid prescriptions to their equivalent daily dose in morphine and divides the total prescription by the number of days the prescription is intended to last – allowing prescribers to more easily compare different opioid formulations and strengths.

This dataset, produced by Sara Heins, PhD, at Johns Hopkins University, explores MEDD threshold policies in effect as of June 1, 2017.

Some key findings include:

  • 22 states have enacted 31 MEDD threshold policies.
  • A majority of states exclude certain patient groups from their MEDD policies. These include terminal/hospice/palliative care patients (12 states), acute/etiologic pain patients (10 states), and cancer/malignant pain patients (8 states).

Explore the map at:

Pain Care Laws and Regulatory Policies

States have a variety of laws and regulatory strategies to govern pain care. These policy mechanisms are often designed to maintain access to appropriate pain management services while also reducing medication misuse.

This dataset provides a snapshot of a broad cross-section of pain care-related policies in the US, in effect as of December 31, 2017. The new state-level data can help researchers evaluate the impact of these laws and policies on patients and individuals at the center of the opioid crisis. It was produced by Aaron Gilson, MS, MSSW, PhD, and Martha Maurer, MSSW, MPH, PhD, both health policy research scientists with the Sonderegger Research Center at the University of Wisconsin–Madison School of Pharmacy.

Some key findings are:

  • 41 states have policies creating an expectation for practitioners to consider integrative care during pain treatment.
  • 34 states have policies that establish an education course for practitioners or pharmacists to improve pain treatment.
  • 18 states have policies that require teaching practitioner or pharmacist users about state Prescription Drug Monitoring Programs.

Explore the map at:

These datasets join more than 80 others across a wide variety of public health topics at, which is the central, authoritative place for policy surveillance data and methods. is operated by the Policy Surveillance Program at Temple University’s Center for Public Health Law Research. Visit to explore.


Bethany Saxon