Law Enforcement Officers’ Perceptions of Florida’s Prescription Drug Monitoring Program

2017 ◽  
Vol 33 (4) ◽  
pp. 368-379 ◽  
Author(s):  
Nicholas M. Perez ◽  
Wesley G. Jennings ◽  
Yanning Wang ◽  
Chris Delcher
Keyword(s):  
Law Enforcement ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
Public Health Problem ◽  
Law Enforcement Officers ◽  
The United States ◽  
Medication Misuse ◽  
Prescription Drug Monitoring Programs ◽  
Effective System

Prescription pain medication misuse and abuse is a considerable criminal justice and public health problem in the United States. As a result, prescription drug monitoring programs (PDMPs) have been developed and implemented across the country to monitor patients with high abuse potential and to detect abnormalities in the prescribing of controlled substances. The current study relies on a sample of 87 Florida law enforcement officers to gauge their perceptions of, use of, and perceived effectiveness of Florida’s PDMP. Results indicate that most of the law enforcement officers considered themselves moderate-to-frequent users of the PDMP and considered the PDMP to be an effective system. In addition, many of the officers reported that their communication had increased with prescribers and pharmacists because of the PDMP. These findings notwithstanding, some officers noted a few barriers/limitations of the PDMP such as “false negatives” and an inability to check another state’s PDMP as areas for improvement. Study limitations and implications are also discussed.

scholarly journals The Effect of Prescription Drug Monitoring Programs on Opioid Utilization in Medicare

2018 ◽  
Vol 10 (1) ◽  
pp. 77-112 ◽  
Author(s):  
Thomas C. Buchmueller ◽  
Colleen Carey
Keyword(s):  
United States ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Medicare Part D ◽  
The United States ◽  
Medicare Part ◽  
Prescription Opioids ◽  
Part D ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs

The misuse of prescription opioids has become a serious epidemic in the United States. In response, states have implemented Prescription Drug Monitoring Programs (PDMPs), which record a patient’s opioid prescribing history. While few providers participated in early systems, states have recently begun to require providers to access the PDMP under certain circumstances. We find that “must access” PDMPs significantly reduce measures of misuse in Medicare Part D. In contrast, we find that PDMPs without such provisions have no effect. We find stronger effects when providers are required to access the PDMP under broad circumstances, not only when they are suspicious. (JEL H75, I11, I12, I18)

scholarly journals Consumer/Patient Encounters with Prescription Drug Monitoring Programs: Evidence from a Medicaid Population

2012 ◽  
Vol 3S;15 (3S;7) ◽  
pp. ES169-ES175
Author(s):  
Amie Goodin
Keyword(s):  
Cancer Pain ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
Claims Data ◽  
Monitoring Program ◽  
Controlled Substances ◽  
Prescription Drug Monitoring Programs ◽  
Medical Need ◽  
Medicaid Population ◽  
Controlled Substance

Background: Prescription drug monitoring programs issue reports about a patient’s controlled substance prescription history upon request to physicians, law enforcement officials, and pharmacists. The dual purposes of these programs are to reduce the abuse and diversion of controlled substances while not preventing access to these medications for legitimate medical need. Objective: The purpose of this study was to examine the experiences of Medicaid patients with Kentucky’s Prescription Drug Monitoring Program (PDMP). Study Design: A random sample of Medicaid patients was surveyed in 2010; respondents were matched with patient retrospective claims data from 6 months prior to the survey’s administration. Study Setting: Kentucky Medicaid patients from across the state. Methods: A combination of patient surveys and Medicaid claims data was used to test the relationship between patient characteristics and patient-reported interactions with physicians regarding their PDMP reports and whether they experienced difficulty obtaining or filling a prescription for a controlled substance due to a PDMP report. Results: Most Medicaid patients are unaffected by the PDMP; however, patients diagnosed with chronic non-cancer pain conditions and patients reporting a Hispanic ethnicity are significantly more likely to have a physician discuss their PDMP report with them. Patients diagnosed with chronic non-cancer pain conditions are also significantly more likely to report difficulty obtaining a prescription for a controlled substance than patients that have not been diagnosed with chronic non-cancer pain conditions. Patients living in rural areas are significantly less likely than patients in urban areas to report difficulty obtaining a prescription for a controlled substance. Limitations: The utilization of controlled substance prescriptions by respondents was not measured or monitored. The Medicaid population examined in this study may not be representative of the population as a whole. Conclusions: These results suggest that more attention to the consumer/patient perspective is warranted in maintaining a balanced approach to decreasing drug abuse and diversion while not limiting access to controlled substances in cases of legitimate medical need Key words: Prescription Drug Monitoring Program, Medicaid, controlled substances, chronic pain patients, patient experiences, KASPER

Trends in Florida's Prescription Drug Monitoring Program registration and utilization: Implications for increasing voluntary use

2017 ◽  
Vol 13 (5) ◽  
pp. 283 ◽  
Author(s):  
Chris Delcher, PhD ◽  
Yanning Wang, MS ◽  
Henry W. Young, MD ◽  
Bruce A. Goldberger, PhD ◽  
Siegfried Schmidt, MD, PhD, FAAFP ◽  
...  
Keyword(s):  
Prescription Drug ◽  
Drug Monitoring ◽  
National Policy ◽  
Monitoring Program ◽  
Meaningful Use ◽  
Utilization Rate ◽  
Cumulative Number ◽  
Policy Goals ◽  
Prescription Drug Monitoring Programs ◽  
Effective Use

Objective: Effective use of state prescription drug monitoring programs (PDMPs) to track controlled substance prescribing and dispensing may help mitigate the current opioid crisis. Our objective was to examine trends in registration for and use of Florida's PDMP by physicians and pharmacists, from 2013 to 2016. We discuss implications for PDMP uptake and policy.Design: Key measures, such as cumulative number of registrants per license type and monthly utilization intensity, are presented. A time series forecasting approach was used to (1) model the monthly count of new PDMP registrants and users from January 2013 to December 2016 and (2) estimate cumulative registration totals after 1 year.Setting: Florida.Results: As of November 2016, there were 16,498 physicians (representing 31 percent of Drug Enforcement Administration licensees) and 17,241 pharmacists registered with the PDMP, representing 21 and 57 percent of professional licensees, respectively. Of note, the PDMP's designation as a “specialized registry” for electronic medical record “meaningful use” criteria led to a nearly sevenfold increase in physician registrations in a single month. In November 2016, pharmacists displayed a higher past-month PDMP utilization rate (52.2 percent vs 30.1 percent), while physicians displayed a higher past-month PDMP utilization intensity (58.1 vs. 36.1 queries per user). Approximately 25,000 physicians and 31,000 pharmacists must register by the end of 2017 to meet national policy goals.Conclusion: PDMP registration among physicians and pharmacists is limited, and the use of the PDMP among registrants is more limited still. Our findings suggest that Florida will not meet national policy goals for registrants by the end of 2017, although new initiatives may alter this trend. Allowing the PDMP to help prescribers meet other professional needs, such as “meaningful use” or similar efforts, may be effective in increasing PDMP use.

Fourth Amendment Protections of Prescription Drug Monitoring Programs: Patient Privacy in the Opioid Crisis

2020 ◽  
Vol 46 (4) ◽  
pp. 375-411
Author(s):  
Ryan Knox
Keyword(s):  
Law Enforcement ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
The State ◽  
Patient Privacy ◽  
Reasonable Expectation ◽  
Opioid Crisis ◽  
Prescription Drug Monitoring Programs ◽  
Search Warrant ◽  
Reasonable Expectation Of Privacy

The opioid crisis is one of the largest public health problems in the history of the United States. Prescription drug monitoring programs (“PDMPs”)—state databases containing the records of all prescriptions for controlled substances written in the state—have emerged as a means to track opioid prescribing and use. While PDMPs are typically used as a tool for physicians to inform their prescribing practices, many states also permit law enforcement to access PDMPs when investigating controlled substance distribution, often without prior judicial approval. Such law enforcement use of PDMPs raises serious questions of patient privacy. The Fourth Amendment protects individuals from unreasonable searches and seizures where they have a reasonable expectation of privacy and has been interpreted to require law enforcement have probable cause and a search warrant before infringing upon an individual’s reasonable expectation of privacy. Several courts have held that patients have no reasonable expectation of privacy, or a severely diminished expectation of privacy, in their prescription drug records held in PDMPs. As support, courts rely on the third-party doctrine because the information is disclosed to physicians and then held by the state; the highly regulated nature of the prescription drug industry; and the statutory framework of the Controlled Substances Act. Such analysis disregards patients’ expectation of privacy in their personal health information, the confidentiality in the physician-patient relationship, and the resulting patient incentives not to seek care. Therefore, this Article argues that law enforcement must have probable cause and a search warrant to access PDMPs because the exceptions to the Fourth Amendment’s probable cause and warrant requirements do not apply.

scholarly journals Mandatory Review of Prescription Drug Monitoring Program Before Issuance of a Controlled Substance Results in Overall Reduction of Prescriptions Including Opioids and Benzodiazepines

2020 ◽  
Vol 3;23 (6;3) ◽  
pp. 299-304
Author(s):  
Alaa Abd-Elsayed
Keyword(s):  
Prescription Drug ◽  
Drug Monitoring ◽  
Monitoring Program ◽  
The United States ◽  
The State ◽  
Prescribing Patterns ◽  
P Value ◽  
Prescription Drug Monitoring Program ◽  
Before And After ◽  
Controlled Substance

Background: To date, there is limited research on whether the various types of mandatory usage of prescription drug monitoring programs (PDMP) have any effects on prescribing patterns, drug usage, patient care, and drug diversion (8-10). Within the United States (US), there is wide variation in individual states’ requirements for the usage of PDMPs. Objective: The objective of this study was to determine whether mandatory prescriber review of a PDMP prior to each issuance of a controlled substance resulted in a reduction in the total number of controlled substance prescriptions dispensed. Study Design: A retrospective review of the State of Wisconsin’s PDMP controlled substance database from April 2015 to March 2019 was performed. The evaluation compared the number of prescriptions among individual drug classes (opioids, benzodiazepines, stimulants) dispensed throughout the state before and after April 1st, 2017, when implementation of a state law mandating the review of the PDMP during each patient encounter prior to issuing a prescription for a controlled substance took effect. Setting: Research was conducted using Wisconsin’s PDMP controlled substance database from April 2015 to March 2019. During this time, controlled substance policy has come to the forefront of the nation due to issues with an opioid epidemic. Methods: Descriptive analysis was used to express data as n and % for categorical data and average ± standard deviation for numerical data. Before- and after-prescription totals were analyzed using a paired t test and Levene’s test for equality of variances. The P value was considered significant at a level ≤ .05. Limitations: Limitations to this study included its retrospective design, focus on a single US state, and possible unforeseen contributors to cause and effect. Results: Prior to the enforcement of the state’s mandatory PDMP legislation, an average of 844,314 controlled substance prescriptions were written monthly. Following the implementation of the law, the average monthly total prescriptions written within the state decreased to 708,063. This was an average monthly reduction of 136,251 prescriptions written or 16.1%. Statistically significant reductions were also seen in opioid and benzodiazepine subgroups (23.0%, 16.3%). Conclusion: Our study suggests that state-enforced mandatory usage of a PDMP, which records all controlled substance prescriptions filled by a pharmacy such as opioids, benzodiazepines, amphetamines, etc. at every encounter prior to prescribing any controlled substance, can provide for a significant reduction in controlled substance prescriptions, specifically opioids and benzodiazepines. Key words: Prescription drug monitoring program, opioids, mandatory usage, benzodiazepines, Wisconsin

scholarly journals Prescription Drug Monitoring Programs and Prescription Opioid–Related Outcomes in the United States

2020 ◽  
Author(s):  
Victor Puac-Polanco ◽  
Stanford Chihuri ◽  
David S Fink ◽  
Magdalena Cerdá ◽  
Katherine M Keyes ◽  
...  
Keyword(s):  
United States ◽  
Substance Use ◽  
Prescription Drug ◽  
Substance Use Disorders ◽  
Drug Monitoring ◽  
The United States ◽  
Mortality Rates ◽  
Prescription Opioid ◽  
Prescription Drug Monitoring Programs ◽  
Opioid Diversion

Abstract Prescription drug monitoring programs (PDMPs) are a crucial component of federal and state governments’ response to the opioid epidemic. Evidence about the effectiveness of PDMPs in reducing prescription opioid–related adverse outcomes is mixed. We conducted a systematic review to examine whether PDMP implementation within the United States is associated with changes in 4 prescription opioid–related outcome domains: opioid prescribing behaviors, opioid diversion and supply, opioid-related morbidity and substance-use disorders, and opioid-related deaths. We searched for eligible publications in Embase, Google Scholar, MEDLINE, and Web of Science. A total of 29 studies, published between 2009 and 2019, met the inclusion criteria. Of the 16 studies examining PDMPs and prescribing behaviors, 11 found that implementing PDMPs reduced prescribing behaviors. All 3 studies on opioid diversion and supply reported reductions in the examined outcomes. In the opioid-related morbidity and substance-use disorders domain, 7 of 8 studies found associations with prescription opioid–related outcomes. Four of 8 studies in the opioid-related deaths domain reported reduced mortality rates. Despite the mixed findings, emerging evidence supports that the implementation of state PDMPs reduces opioid prescriptions, opioid diversion and supply, and opioid-related morbidity and substance-use disorder outcomes. When PDMP characteristics were examined, mandatory access provisions were associated with reductions in prescribing behaviors, diversion outcomes, hospital admissions, substance-use disorders, and mortality rates. Inconsistencies in the evidence base across outcome domains are due to analytical approaches across studies and, to some extent, heterogeneities in PDMP policies implemented across states and over time.

A History of Prescription Drug Monitoring Programs in the United States: Political Appeal and Public Health Efficacy

2020 ◽  
Vol 110 (8) ◽  
pp. 1191-1197
Author(s):  
A. Jay Holmgren ◽  
Alyssa Botelho ◽  
Allan M. Brandt
Keyword(s):  
Public Health ◽  
United States ◽  
Prescription Drug ◽  
Drug Monitoring ◽  
The United States ◽  
Administrative Databases ◽  
Opioid Crisis ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs ◽  
History Of

Prescription drug monitoring programs (PDMPs) have become a widely embraced policy to address the US opioid crisis. Despite mixed scientific evidence on their effectiveness at improving health and reducing overdose deaths, 49 states and Washington, DC have adopted PDMPs, and they have received strong bipartisan legislative support. This article explores the history of PDMPs, tracking their evolution from paper-based administrative databases in the early 1900s to modern-day electronic systems that intervene at the point of care. We focus on two questions: how did PDMPs become so widely adopted in the United States, and how did they gain popularity as an intervention in the contemporary opioid crisis? Through this historical approach, we evaluate what PDMPs reflect about national drug policy and broader cultural understandings of substance use disorder in the United States today. (Am J Public Health. 2020;110:1191–1197. 10.2105/AJPH.2020.305696)

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.

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