Fig 1.
Abbreviated directed acyclic graph of buprenorphine initiation and prescription drug monitoring program data elements.
Elements shown in gray squares cannot be directly observed in Prescription Drug Monitoring (PDMP) data, while elements in white ovals can be observed.
Fig 2.
Daily prescribing of controlled substances by class, North Carolina, 2011-2015.
During the study period, immediate release full mu opioid receptor agonist and agonist prodrug analgesics accounted for the most controlled substance prescriptions daily. The class of controlled substances with the greatest absolute and relative change was the weak opioid analgesic class. This was due to the scheduling of tramadol as a C-IV controlled substance during the study period.
Fig 3.
Oral full mu-agonist opioid analgesic and transdermal fentanyl dispensing by active pharmaceutical ingredient, North Carolina, 2011–2015.
Notable market regulatory changes to full mu-agonists during the study period included the introduction of hydrocodone extended-release (ER), and the rescheduling of hydrocodone/acetaminophen from a C-III to C-II controlled substance. Hydrocodone ER dispensing was very low and would not be interpretable on the scale of this figure.
Table 1.
Time-to-event analysis cohort of opioid analgesic patients in North Carolina, 2011–2015.
Table 2.
Proportional hazards regression of first buprenorphine initiation among North Carolina opioid analgesic recipients, 2011–2015.
Fig 4.
Multivariate adjusted Hazard Ratios of first buprenorphine initiation among North Carolina opioid analgesic recipients, 2011-2015.
Note that the Hazard Ratios are plotted on a logarithmic scale.