Implementation Of Prescription Drug Monitoring Programs Associated With Reductions In Opioid-Related Death Rates

Abstract

Over the past two decades the number of opioid pain relievers sold in the United States rose dramatically. This rise in sales was accompanied by an increase in opioid-related overdose deaths. In response, forty-nine states (all but Missouri) created prescription drug monitoring programs to detect high-risk prescribing and patient behaviors. Our objectives were to determine whether the implementation or particular characteristics of the programs were effective in reducing opioid-related overdose deaths. In adjusted analyses we found that a state's implementation of a program was associated with an average reduction of 1.12 opioid-related overdose deaths per 100,000 population in the year after implementation. Additionally, states whose programs had robust characteristics-including monitoring greater numbers of drugs with abuse potential and updating their data at least weekly-had greater reductions in deaths, compared to states whose programs did not have these characteristics. We estimate that if Missouri adopted a prescription drug monitoring program and other states enhanced their programs with robust features, there would be more than 600 fewer overdose deaths nationwide in 2016, preventing approximately two deaths each day.

Keywords: Epidemiology; Health Promotion/Disease Prevention; Mental Health/Substance Abuse; Pharmaceuticals; Public Health.

EXHIBIT 2. Prescription opioid–related deaths in the United States, 2013

SOURCE Authors’ analysis of data from the National Center for Health Statistics, National Vital Statistics System, and Detailed Mortality File, all accessed through CDC WONDER (see Note 32 in text). NOTES Appendix Exhibit 1 shows the growth of these deaths and the spread of prescription drug monitoring programs in the thirty-four states in our sample over the entire study period (see Note 36 in text). Appendix Exhibit 5 consists of a graphical representation of the change in opioid-related overdose deaths for the study period (see Note 36 in text). North Dakota value suppressed as explained in the text.

EXHIBIT 4. Opioid-related overdose death rates, by use and features of prescription drug monitoring programs

SOURCE Authors’ analysis of data from the sources listed in Exhibit 1. NOTES Model 1 includes data for all states that implemented a PDMP during our study period. Model 2 excludes West Virginia.