应对阿片类药物滥用：药物剂量警示系统的作用

阿片类药物危机已演变为全球性的公共卫生紧急事件，其严重后果在美国尤为突出。医师过度开具阿片类药物作为此危机的重要驱动因素，加剧了阿片类药物的滥用问题。药物剂量警示系统，作为一种有效的干预手段，能在医师开具的药物剂量超出推荐范围时及时发出警示，从而防止药物的过度使用。本文致力于探讨此系统在应对阿片类药物滥用问题上的实际效果。利用2012年2月至2017年12月纽约州165家医院的面板数据，本文采用双重差分法和反事实估计量对药物剂量警示系统的实施效果进行了严谨的实证分析。研究结果显示，该系统的实施显著降低了医院每月因阿片类药物使用障碍疾病导致的门诊数和患者数，证实了其在减少阿片类药物滥用方面的积极作用。此外，本文还深入探讨了门诊慢性疼痛患者占比和医院教学性质对药物剂量警示系统有效性的影响。同时，通过对包含231名医师和16868个观察值的面板数据的分析，本文揭示了药物剂量警示系统在减少阿片类药物使用障碍疾病的作用机理。研究结果表明，药物剂量警示系统显著降低了医师开具的阿片类药物剂量，而且其效果受到开具药物的滥用风险和医师执业年限的调节。本文的研究结果凸显了药物剂量警示系统在确保阿片类药物安全开具、有效遏制阿片类药物滥用现象中的重要作用。

The opioid epidemic has had profound global implications, particularly within the United States. Opioid overprescribing by prescribers is a primary contributing factor, as it could facilitate opioid abuse. Drug dosage alert systems provide real-time alerts to prescribers when they prescribe doses exceeding the recommended ranges. This would prevent opioid overprescribing and consequently reduce opioid abuse. This study examines the effectiveness of drug dosage alert systems in curbing opioid abuse incidents. Utilizing a hospital-level panel dataset encompassing 165 hospitals in New York state from February 2012 to December 2017, we employ difference-in-differences and counterfactual estimates to analyze the impacts of drug dosage alert system implementation. Our results indicate that the implementation of drug dosage alert systems significantly reduces monthly outpatient hospital visits and patient numbers due to opioid use disorder. Furthermore, we explore the impacts of the proportion of outpatients due to chronic pain, and the teaching status of hospitals on the effectiveness of drug dosage alert systems in addressing opioid abuse issues. Additionally, through analysis of panel data comprising 231 prescribers and 16,868 observations, we investigate the mechanism underlying the effectiveness of drug dosage alert systems. Our findings reveal that drug dosage alert systems significantly reduce the prescribed dosage of opioid medications by prescribers, with this relationship being influenced by the opioid abuse potential of prescribed opioids and the years of practice of prescribers. Our findings highlight the important role of drug dosage alert systems in promoting safer opioid prescribing practices and curbing opioid abuse.

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