Must-Access Prescription Drug Monitoring Programs and the Opioid Overdose Epidemic: The Unintended Consequences

2020 ◽  
Author(s):  
Bokyung Kim
Keyword(s):  
Prescription Drug ◽  
Drug Monitoring ◽  
Unintended Consequences ◽  
Opioid Overdose ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs

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.

Perceived Unintended Consequences of Prescription Drug Monitoring Programs

2018 ◽  
Vol 54 (2) ◽  
pp. 345-349 ◽  
Author(s):  
Alden Yuanhong Lai ◽  
Katherine C. Smith ◽  
Jon S. Vernick ◽  
Corey S. Davis ◽  
G. Caleb Alexander ◽  
...  
Keyword(s):  
Prescription Drug ◽  
Drug Monitoring ◽  
Unintended Consequences ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs

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)

scholarly journals Effects of Implementation and Enforcement Differences in Prescription Drug Monitoring Programs in 3 States: Connecticut, Kentucky, and Wisconsin

2021 ◽  
Vol 15 ◽  
pp. 117822182199234
Author(s):  
Julia Dickson-Gomez ◽  
Erika Christenson ◽  
Margaret Weeks ◽  
Carol Galletly ◽  
Jennifer Wogen ◽  
...  
Keyword(s):  
Prescription Drug ◽  
Drug Monitoring ◽  
Unintended Consequences ◽  
Pain Clinic ◽  
Opioid Misuse ◽  
Medical Providers ◽  
Opioid Use ◽  
Key Informants ◽  
Monitoring Programs ◽  
Prescription Drug Monitoring Programs

Background and aims: Prescription Drug Monitoring Programs (PDMPs) were designed to curb opioid misuse and diversion by tracking scheduled medications prescribed by medical providers and dispensed by pharmacies. The effects of PDMPs on opioid prescription, misuse and overdose rates have been mixed due in part to variability in states’ PDMPs and difficulties measuring this complexity, and a lack of attention to implementation and enforcement of PDMP components. The current study uses qualitative interviews with key informants from 3 states with different PDMPs, Connecticut, Kentucky and Wisconsin to explore differences in the characteristics of the PDMPs in each state; how they are implemented, monitored and enforced; and unintended negative consequences of these programs. Methods: We conducted in-depth interviews with key informants from each state representing the following sectors: PDMP and pain clinic regulation agencies, Medicaid programs, state licensing boards, pharmacies, emergency medicine departments, pain management clinics, first responders, drug courts, drug treatment programs, medication assisted treatment (MAT) providers, and harm reduction organizations. Interview guides explored participants’ experiences with and opinions of PDMPs according to their roles. Data analysis was conducted using a collaborative, constant comparison method. Results: While all 3 states had mandated registration and reporting requirements, the states differed in the implementation and enforcement of these and the extent to which provider prescribing was monitored. These, in turn, influenced how medical providers perceived the PDMP and changed how providers prescribed opioids. Unintended consequences of state PDMPs included under-prescribing for pain and “dumping” patients who were long term users of opioids or who had developed opioid use disorders and may explain the increase in illicit heroin or opioid use. Conclusion: State PDMPs with similar mandates may differ greatly in implementation and enforcement. These differences are important to consider when determining the effects of PDMPs on opioid misuse and overdose.

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