Prescription drug monitoring and dispensing of prescription opioids

Public Health Rep. Mar-Apr 2014;129(2):139-47. doi: 10.1177/003335491412900207.

Abstract

Objective: In the United States, per-capita opioid dispensing has increased concurrently with analgesic-related mortality and morbidity since the 1990s. To deter diversion and abuse of controlled substances, most states have implemented electronic prescription drug monitoring programs (PDMPs). We evaluated the impact of state PDMPs on opioid dispensing.

Methods: We acquired data on opioids dispensed in a given quarter of the year for each state and the District of Columbia from 1999 to 2008 from the Automation of Reports and Consolidated Orders System and converted them to morphine milligram equivalents (MMEs). We used multivariable linear regression modeling with generalized estimating equations to assess the effect of state PDMPs on per-capita dispensing of MMEs.

Results: The annual MMEs dispensed per capita increased progressively until 2007 before stabilizing. Adjusting for temporal trends and demographic characteristics, implementation of state PDMPs was associated with a 3% decrease in MMEs dispensed per capita (p=0.68). The impact of PDMPs on MMEs dispensed per capita varied markedly by state, from a 66% decrease in Colorado to a 61% increase in Connecticut.

Conclusions: Implementation of state PDMPs up to 2008 did not show a significant impact on per-capita opioids dispensed. To control the diversion and abuse of prescription drugs, state PDMPs may need to improve their usability, implement requirements for committee oversight of the PDMP, and increase data sharing with neighboring states.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Databases, Factual
  • Drug Monitoring / methods
  • Drug Monitoring / statistics & numerical data
  • Drug Overdose / epidemiology
  • Drug Overdose / mortality
  • Drug and Narcotic Control / methods*
  • Drug and Narcotic Control / statistics & numerical data
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Prescription Drug Diversion / statistics & numerical data*
  • Prescription Drug Misuse / mortality
  • Prescription Drug Misuse / statistics & numerical data*
  • Prescription Drugs / adverse effects
  • Prescription Drugs / therapeutic use
  • Sex Distribution
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / etiology*
  • Substance-Related Disorders / mortality
  • United States / epidemiology
  • Young Adult

Substances

  • Analgesics, Opioid
  • Prescription Drugs