The opioid problem in the United States is nothing new. Every day, doctors prescribe more than 650,000 prescriptions — and an average 78 of those people die of an overdose. It's an epidemic Americans have been struggling to curb for years, and despite many laws and programs designed to help, the issue remains.

When the number of overdose deaths quadrupled between the years of 2006 and 2012, 81 states passed laws that restricted how doctors prescribe opioids, how pharmacies dispense them, and how people ultimately receive them. Unfortunately, according to new research out of The Dartmouth Institute of Health Policy and Clinical Practice and UCLA School of Law, these laws had no measureable effect on a particularly vulnerable part of the population: Medicare's disabled beneficiaries. These are people under the age of 65 who qualify for Medicare coverage because they are totally and permanently disabled.

Not only does this group see high rates of opioid use but they are also more likely to live in poverty and deal with other complex medical conditions than the general population. “Because of their high rate of death from prescription opioid overdose, they could have benefited from effective regulation,” said lead study author Dr. Ellen Meara in a press release. “However, they laws appear weak and slow relative to the epidemic they aim to curb.”

For the study, Meara and her colleagues analyzed the effect of state laws on opioid use among 2.2 million disabled patients between the ages of 21 and 64. The results of their examination were disheartening — there was no significant association between new laws and problematic prescription patterns. While there was a small dip in the population receiving opioids from multiple prescribers in states that enacted multiple laws, the change was not statistically significant.

There was also no measureable association between the percentage of beneficiaries filling prescriptions that lead to opioid overdoses or the percentage of those treated for nonfatal prescription-opioid overdose, the study authors wrote.

However, after 20 state officials strengthened laws in 2012 that require doctors to consult a prescription drug monitoring programs before they prescribe to a new patient, there's been some improvement. And this trend is the authors’ next target for research.

“Successful prescription opioid regulation should strike the hard balance between controlling misuse and fostering compassionate pain management," said senior study author Dr. Nancy Morden, also a primary care physician. "Clinicians need to carefully consider their rile in prescription opioid misuse and overdose.”

Meara added that although opioid abuse is a significant public health problem, enacting laws and prescription drug monitoring programs is expensive for states. 

“Our findings indicate they don’t do much to curb opioid abuse or overdose, at least in this vulnerable population," she said. "States might have to invest more resources in evaluating the effectiveness of legislation.”

Source: Meara E, Horwitz J, Powell W, McClelland L, Zhou W, O’Malley J, et al. State Legal Restrictions and Prescription-Opioid Use Among Disabled Adults. The New England Journal of Medicine. 2016.