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Background: To curb the opioid epidemic, legislation regulating the amount ofopioid prescriptions covered by Medicaid (Title XIX of the Social Security ActMedical Assistance Program) came into effect in May 2018 in South Carolina.Methods: We employ a classification system based on distance and disparitybetween dispensers, prescribers, and patients and conduct an ARIMA analysis oneach class and without any class to examine the effect of the legislation onopioid prescriptions, considering secular trends and autocorrelation. The studyalso compares trends in benzodiazepine prescriptions as a control. Results: Theproposed classification system clusters each transaction into 16 groups basedon the location of the stakeholders. These categories were found to havedifferent prescription volume levels, with the highest group averaging 96.50 indaily MME (95% CI [63.43, 99.57]) and the lowest 37.78 (95% CI [37.38,38.18]).The ARIMA models show a decrease in overall prescription volume from 53.68 (95%CI [53.33,54.02]) to 51.09 (95% CI [50.74,51.44]) and varying impact across thedifferent classes. Conclusion: Policy was effective in reducing opioidprescription volume overall. However, the volume of prescriptions filled wherethe prescribing doctor is located more than 1000 miles away from the patientwent up, hinting at the possibility of doctor shopping.

The Impact of Opioid Prescribing Limits on Drug Usage in South Carolina: A Novel Geospatial and Time Series Data Analysis