Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

APSA 2025 Abstract Book

Abstract

Abstract: Background: In December 2017, Michigan enacted Public Act 246(P246) to address rising opioid misuse. P246 states that, as of June 1, 2018, a prescriber of a controlled substance must discuss the risks of opioid addiction, overdose, and the dangers of taking opioids with benzodiazepine, alcohol or any other nervous system depressant with the minor and the minor’s parent or guardian. This study aims to evaluate the impact of this legislation by comparing opioid morphine milligram equivalents (MME) prescribed to pediatric patients undergoing common general, urological, and ENT surgeries before and after June 1, 2018. Methods: A single-center, retrospective chart review of pediatric patients who underwent circumcision, inguinal hernia repair, umbilical hernia repair, tympanostomy, tonsillectomy, or adenoidectomy between 2015 and 2021. MME was calculated from post-operative opioid prescriptions. Descriptive statistics, univariate, and multivariable analysis was performed, looking at changes in MME prescribed pre- and post- P246. Results: A total of 7,280 patients, with a mean age of 3.1 years were included in the study; 3,512 pre-P246 and 3,786 post-P246. The post-P246 group included significantly more males (75.7 vs. 72.6%) and those with government insurance (34.5 vs 22.2%). There was no significant difference in age between the two groups. Children undergoing surgery after implementation of the law were found to have been prescribed 4.9 mg MME less than those before implementation (7.69 vs. 3.20, p< 0.0001). A multi-variate linear regression model, adjusting for age, surgery date, and specialty, showed that all three surgical specialties had a significant reduction in prescribed MME post-P246. Children undergoing circumcision, inguinal herniorrhaphy, and umbilical herniorrhaphy had significantly reduced MME prescribed to them after June 1, 2018. However, no significant decrease was observed for tympanostomy, tonsillectomy, and adenoidectomy. Conclusion: Michigan Public Act 246 was significantly associated with a 58% reduction in prescription opioids for pediatric patients after routine surgery. These findings suggest that guardianship education about risks of opioid usage can significantly influence prescribing practices for pediatric surgical specialties, demonstrating the potential of legislation in promoting opioid stewardship

First Page

325

Last Page

326

Comments

American Pediatric Surgical Association, APSA Annual Meeting, May 7-10, 2025, Montreal, Canada

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