Surveillance, Self-Governance, and Mortality: The Impact of Prescription Drug Monitoring Programs on U.S. Overdose Mortality, 2000–2016

2022 ◽  
pp. 002214652110672
Author(s):  
Mike Vuolo ◽  
Laura C. Frizzell ◽  
Brian C. Kelly
Keyword(s):  
Prescription Drug ◽  
Population Health ◽  
Drug Monitoring ◽  
Self Regulation ◽  
Opioid Overdose ◽  
Require Time ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs ◽  
Overdose Mortality ◽  
The Impact

Policy mechanisms shaping population health take numerous forms, from behavioral prohibitions to mandates for action to surveillance. Rising drug overdoses undermined the state’s ability to promote population-level health. Using the case of prescription drug monitoring programs (PDMPs), we contend that PDMP implementation highlights state biopower operating via mechanisms of surveillance, whereby prescribers, pharmacists, and patients perceive agency despite choices being constrained. We consider whether such surveillance mechanisms are sufficient or if prescriber/dispenser access or requirements for use are necessary for population health impact. We test whether PDMPs reduced overdose mortality while considering that surveillance may require time to reach effectiveness. PDMPs reduced opioid overdose mortality 2 years postimplementation and sustained effects, with similar effects for prescription opioids, benzodiazepines, and psychostimulants. Access or mandates for action do not reduce mortality beyond surveillance. Overall, PDMP effects on overdose mortality are likely due to self-regulation under surveillance rather than mandated action.

The Impact of Prescription Drug Monitoring Programs on U.S. Opioid Prescriptions

2018 ◽  
Vol 46 (2) ◽  
pp. 387-403 ◽  
Author(s):  
Ian Ayres ◽  
Amen Jalal
Keyword(s):  
Prescription Drug ◽  
Drug Monitoring ◽  
Fixed Effects ◽  
Treatment Effects ◽  
State Level ◽  
Opioid Prescription ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs ◽  
Prescription Rates ◽  
The Impact

This paper seeks to understand the treatment effect of Prescription Drug Monitoring Programs (PDMPs) on opioid prescription rates. Using county-level panel data on all opioid prescriptions in the U.S. between 2006 and 2015, we investigate whether state interventions like PDMPs have heterogeneous treatment effects at the sub-state level, based on regional and temporal variations in policy design, extent of urbanization, race, and income. Our models comprehensively control for a set of county and time fixed effects, countyspecific and time-varying demographic controls, potentially endogenous time-series trends in prescription rates, and other state-level opioid interventions such as Naloxone Access and Good Samaritan laws, Medicaid expansion, and the provision of Methadone Assistance Treatment. We find that PDMPs are only effective in reducing prescription rates if they obligate doctors to check for patients' history prior to filling out a prescription, but the frequency at which a state requires its PDMP to be updated is irrelevant to its effectiveness. Moreover, the significant treatment effects of PDMPs are almost exclusively driven by urban and predominantly white counties, with the relatively more affluent regions showing greater responsiveness than their less affluent counterparts.

The Role of Prescription Drug Monitoring Programs (PDMPs) in Addressing the Opioid Overdose Epidemic

2019 ◽  
pp. 265-292 ◽  
Author(s):  
Grant Baldwin ◽  
Jan L. Losby ◽  
Wesley M. Sargent ◽  
Jamie Mells ◽  
Sarah Bacon
Keyword(s):  
Public Health ◽  
Law Enforcement ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Prescribing Patterns ◽  
Opioid Overdose ◽  
Monitoring Programs ◽  
Stewardship Program ◽  
Prescription Drug Monitoring Programs ◽  
Law Enforcement Officials

Prescription drug monitoring programs (PDMPs) are secure, online, state-based databases that contain information about controlled substance prescriptions written by clinicians and dispensed by pharmacists within a jurisdiction. In this chapter, current and future trends impacting PDMPs are reviewed and the implication of these trends for the future development of even more effective PDMPs is discussed. Uses of PDMPs by public health partners are also reviewed. For example, law enforcement officials may use data collected by PDMPs when investigating unusual prescribing patterns. Law enforcement officials may also use PMDP data in drug courts and other criminal diversion programs. Medical licensing boards use PMDP data to assess aberrant prescribing practices. Health systems, insurers, and public health officials use aggregated PDMP data as part of their efforts to evaluate a quality improvement initiative, an opioid stewardship program to improve opioid prescribing system-wide, or broad changes to prescribing patterns across a city, county, or state.

scholarly journals U.S. Opioid Epidemic: Impact on Public Health and Review of Prescription Drug Monitoring Programs (PDMPs)

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Sunghee H Bote
Keyword(s):  
Public Health ◽  
Decision Support ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Targeted Interventions ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs ◽  
The U.S

Objectives: In recent years, the devastating effects of U.S. opioid epidemic has been making news headlines.  This report explores background information and trends on opioid misuse, overdose fatalities and its impact on public health.  In addition, various efforts to improve surveillance, timeliness of data and Prescription Drug Monitoring Program (PDMP) integration and interoperability are reviewed.Method: PubMed and internet searches were performed to find information on the U.S. opioid epidemic.  In addition, searches were performed to retrieve information about PDMPs and state-specific mandates along with presentation slides and learnings from the 2018 National Rx Drug Abuse & Heroin Summit in Atlanta, GA.Results: It is clear that the U.S. opioid epidemic has a tremendous impact on public health including the next generation of children.  Various data, surveillance & technology-driven efforts including CDC-Funded Enhanced State Opioid Overdose Surveillance Program (ESOOS) and use of telemedicine for opioid use disorder treatment aim to improve prevention, treatment and targeted interventions.  In addition, PDMP integration and interoperability efforts are advancing to provide prescribers meaningful decision support tools.Discussion: The opioid epidemic has a complex impact on public health intertwined with variable factors such as mental health and social determinants of health.  Given the statistics and studies that suggest many of the illicit opioid users start with prescription opioids, continued advancement in the area of PDMP integration and interoperability is necessary.  The PDMP integrated clinical decision support systems need to supply to healthcare providers access to complete, timely and evidence-based information that can meaningfully inform prescribing decisions and communication with patients that affect measurable outcomes. Conclusion: While Prescription Drug Monitoring Programs (PDMPs) are valuable tools for providers in making informed prescribing decisions, the variable state mandates and varying degrees of integration and interoperability across states may limit their potential as meaningful decision support tools.  Sharing best practices, challenges and lessons learned among states and organizations may inform strategic and systematic use of PDMPs to improve public health outcomes.Key Words: opioid epidemic, prescription drug monitoring programs (PDMPs), prescription monitoring programs (PMPs)

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