Prescription drug monitoring and drug overdose mortality

Objectives: To determine whether specific state legislation has an effect on opioid overdose mortality rates compared to states without those types of legislation. Design: Ecological study estimating opioid-related mortality in states with and without a prescription drug monitoring program (PDMP) and/or medical cannabis legislation.Setting and participants: Opioid-related mortality rates for 50 states and Washington DC from 2011 to 2014 were obtained from CDC WONDER. PDMP data were obtained from the National Alliance for Model State Drug Laws, and data on medical cannabis legislation from the National Organization for the Reform of Marijuana Laws.Main outcomes and measures: The relationship between PDMPs with mandatory access provisions, medical cannabis legislation, and opioid-related mortality rates. Methods: Multivariate repeated measures analysis performed with software and services.Results: Medical cannabis laws were associated with an increase of 21.7 percent in mean age-adjusted opioid-related mortality (p < 0.0001). PDMPs were associated with an increase of 11.4 percent in mean age-adjusted opioid-related mortality (p = 0.005). For every additional year since enactment, mean age-adjusted opioid-related mortality rate increased by 1.7 percent in states with medical cannabis (p = 0.049) and 5.8 percent for states with a PDMP (p = 0.005). Interaction between both types of legislation produced a borderline significant decrease of 10.1 percent (p = 0.055). For every year states had both types of legislation, interaction resulted in a 0.6 percent decrease in rate (p = 0.013).Conclusion: When combined with the availability of medical cannabis as an alternative analgesic therapy, PDMPs may be more effective at decreasing opioid-related mortality.

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Prescription drug monitoring programs and drug overdose deaths involving benzodiazepines and prescription opioids

Drug and Alcohol Review ◽

10.1111/dar.12959 ◽

2019 ◽

Vol 38 (5) ◽

pp. 494-502 ◽

Cited By ~ 3

Author(s):

Di Liang ◽

Yuyan Shi

Keyword(s):

Prescription Drug ◽

Drug Overdose ◽

Drug Monitoring ◽

Prescription Opioids ◽

Monitoring Programs ◽

Prescription Drug Monitoring Programs ◽

Overdose Deaths

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Prescription Drug Abuse in Texas: Mortality and its Economic Consequences

Journal of Drug Education ◽

10.2190/jduw-mr53-yqj6-f0j2 ◽

1981 ◽

Vol 11 (1) ◽

pp. 77-82 ◽

Cited By ~ 1

Author(s):

Kirk Harlow ◽

J. Michael Swint

Keyword(s):

Drug Abuse ◽

Prescription Drug ◽

Drug Overdose ◽

Economic Cost ◽

Economic Consequences ◽

Careful Examination ◽

Prescription Drug Abuse ◽

Total Drug ◽

Overdose Mortality ◽

Benefits And Costs

Prescription drug overdose mortality is documented and its economic consequences estimated for Texas in 1978. 117 of 397 total drug related deaths were due to the use of barbiturates, tranquilizers, and anti-depressants. Another eighty-five deaths were due to mixing these with other drugs. The economic cost of mortality exceeded $43 million, of which 52 per cent was due to prescription drug overdose. Given questions concerning the efficacy of these drugs, the results indicate a need for a more careful examination of the relative benefits and costs of their continued widespread use.

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Prescription Drug Monitoring Programs and Death Rates from Drug Overdose

Pain Medicine ◽

10.1111/j.1526-4637.2011.01062.x ◽

2011 ◽

Vol 12 (5) ◽

pp. 747-754 ◽

Cited By ~ 228

Author(s):

Leonard J. Paulozzi ◽

Edwin M. Kilbourne ◽

Hema A. Desai

Keyword(s):

Prescription Drug ◽

Drug Overdose ◽

Drug Monitoring ◽

Death Rates ◽

Monitoring Programs ◽

Prescription Drug Monitoring Programs

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

Journal of Health and Social Behavior ◽

10.1177/00221465211067209 ◽

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.

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Revisiting Paulozzi et al.'s “Prescription Drug Monitoring Programs and Death Rates from Drug Overdose”: Table 1

Pain Medicine ◽

10.1111/j.1526-4637.2011.01136.x ◽

2011 ◽

Vol 12 (6) ◽

pp. 982-985 ◽

Cited By ~ 17

Author(s):

Traci C. Green ◽

Nickolas Zaller ◽

Josiah Rich ◽

Sarah Bowman ◽

Peter Friedmann

Keyword(s):

Prescription Drug ◽

Drug Overdose ◽

Drug Monitoring ◽

Death Rates ◽

Monitoring Programs ◽

Prescription Drug Monitoring Programs

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Impact of prescription drug monitoring program mandate on postoperative opioid prescriptions in children

Pediatric Surgery International ◽

10.1007/s00383-020-04846-2 ◽

2021 ◽

Author(s):

Christina M. Theodorou ◽

Jordan E. Jackson ◽

Ganesh Rajasekar ◽

Miriam Nuño ◽

Kaeli J. Yamashiro ◽

...

Keyword(s):

Time Series ◽

Time Series Analysis ◽

Prescription Drug ◽

Drug Monitoring ◽

Monitoring Program ◽

Interrupted Time Series ◽

Surgical Patients ◽

Interrupted Time Series Analysis ◽

Opioid Prescription ◽

Series Analysis

Abstract Purpose Prescription drug monitoring programs (PDMPs) have been established to combat the opioid epidemic, but there is no data on their efficacy in children. We hypothesized that a statewide PDMP mandate would be associated with fewer opioid prescriptions in pediatric surgical patients. Methods Patients < 18 undergoing inguinal hernia repair, orchiopexy, orchiectomy, appendectomy, or cholecystectomy at a tertiary children’s hospital were included. The primary outcome, discharge opioid prescription, was compared for 10 months pre-PDMP (n = 158) to 10 months post-PDMP (n = 228). Interrupted time series analysis was performed to determine the effect of the PDMP on opioid prescribing. Results Over the 20-month study period, there was an overall decrease in the rate of opioid prescriptions per month (− 3.6% change, p < 0.001). On interrupted time series analysis, PDMP implementation was not associated with a significant decrease in the monthly rate of opioid prescriptions (1.27% change post-PDMP, p = 0.4). However, PDMP implementation was associated with a reduction in opioid prescriptions of greater than 5 days’ supply (− 2.7% per month, p = 0.03). Conclusion Opioid prescriptions declined in pediatric surgical patients over the study time period. State-wide PDMP implementation was associated with a reduction in postoperative opioid prescriptions of more than 5 days’ duration.

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