Technical Preprint: Rationale and Design of a Planned Observational Study to Evaluate the Impact of Hydrocodone Rescheduling on Opioid Prescribing After Surgery

In October 2014, the US Drug Enforcement Agency (DEA) reclassified hydrocodone from Schedule III to Schedule II of the Controlled Substances Act, resulting in a prohibition on refills in the initial prescription. While this schedule change was associated with overall decreases in the rate of filled hydrocodone prescriptions and opioid dispensing, available studies conflict regarding its impact on acute opioid prescribing among surgical patients. Here, we present the rationale and design of a planned study to measure the effect of hydrocodone rescheduling using a difference-in-differences design that leverages anticipated variation in the relative impact of this policy on patients treated by surgeons that more or less frequently prescribed hydrocodone products versus other opioids prior to the schedule change. Additionally, we present findings from preliminary study conducted on a subset of our full planned sample to assess for potential differences in outcome trends over the 3 years prior to rescheduling among patients treated by surgeons who commonly prescribed hydrocodone versus those treated by surgeons who rarely prescribed hydrocodone.