Enhancing Prescription Drug Monitoring Programs (PDMPs) and Mandating their Use
Every U.S. state has a PDMP, an electronic database that tracks controlled substance prescriptions. They are intended to reduce “doctor shopping” and to prevent patients from being prescribed dangerous drug combinations by different doctors.
However, not all states require prescribers to check the PDMP when dispensing opioids and other controlled substances. PDMPs cannot protect patients if health care providers do not use them as a resource.
PDMPs allow health care providers to see patients’ prescription histories before making decisions regarding future prescriptions. They can -- and should-- also be used by state health departments to understand the nature of the epidemic and to evaluate potential solutions.
Some states have begun requiring prescribers and/or pharmacists to check the PDMP when prescribing or dispensing opioids and other controlled substances (e.g., benzodiazepines).
PDMPs can help reduce doctor-shopping, but only if they are well-designed and properly resourced.
Because addicted patients identified as doctor-shoppers may switch from prescription opioids to heroin/fentanyl, effective addiction treatment must be made available to avoid unintended effects of PDMPs.
Key Policy Evidence:
- Evaluations of state PDMPs usually find that they modestly reduce opioid prescribing and prescription opioid overdoses.
- Because PDMPs may stimulate some opioid-addicted individuals to switch from prescription opioids to heroin/fentanyl, the benefit they produce in reducing prescription opioid overdoses may be cancelled out by increases in illicit opioid overdoses, at least in the short term.
- A U.S.-wide study found that when prescribers are mandated to check the PDMP, prescription opioid deaths decreased by 9% and benzodiazepine deaths decreased by 11%.
- A study of PDMP quality found that they were more effective at reducing prescription opioid overdose deaths when they mandated prescriber use, had an oversight board and evaluation of effectiveness, and received stable funding.