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)

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.

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.

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)

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