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

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.

[1]  Thomas R Frieden,et al.  Medication-assisted therapies--tackling the opioid-overdose epidemic. , 2014, The New England journal of medicine.

[2]  Rose A Rudd,et al.  Increases in Drug and Opioid Overdose Deaths--United States, 2000-2014. , 2016, MMWR. Morbidity and mortality weekly report.

[3]  K. Murray,et al.  Out-of-hospital mortality among patients receiving methadone for noncancer pain. , 2015, JAMA internal medicine.

[4]  Matthew M Davis,et al.  Erratum: Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012 (Journal of Perinatology (2015) 35 (667)) doi:10.1038/jp.2015.63 , 2015 .

[5]  Dennis McCarty,et al.  Measures such as interstate cooperation would improve the efficacy of programs to track controlled drug prescriptions. , 2013, Health affairs.

[6]  Kun Zhang,et al.  Prescription Practices involving Opioid Analgesics among Americans with Medicaid, 2010 , 2015, Journal of health care for the poor and underserved.

[7]  E. Quinn,et al.  Overdose Education and Naloxone Rescue Kits for Family Members of Individuals who Use Opioids: Characteristics, Motivations, and Naloxone Use , 2015, Substance abuse.

[8]  Tamara M Haegerich,et al.  What we know, and don't know, about the impact of state policy and systems-level interventions on prescription drug overdose. , 2014, Drug and alcohol dependence.

[9]  E. Vuori,et al.  Personally prescribed psychoactive drugs in overdose deaths among drug abusers: a retrospective register study. , 2015, Drug and alcohol review.

[10]  P. DasMahapatra,et al.  Changes in prevalence of prescription opioid abuse after introduction of an abuse-deterrent opioid formulation. , 2014, Pain medicine.

[11]  F. Harrell,et al.  Prescription Opioid Epidemic and Infant Outcomes , 2015, Pediatrics.

[12]  Leonard J. Paulozzi,et al.  Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012 , 2014, MMWR. Morbidity and mortality weekly report.

[13]  Lainie Rutkow,et al.  Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access. , 2015, Health affairs.

[14]  Erin M. Johnson,et al.  Risk factors for prescription opioid-related death, Utah, 2008-2009. , 2012, Pain medicine.

[15]  S. Cole,et al.  Overadjustment Bias and Unnecessary Adjustment in Epidemiologic Studies , 2009, Epidemiology.

[16]  J. McAllister,et al.  Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009. , 2012, JAMA.

[17]  C. Cunningham,et al.  Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. , 2014, JAMA internal medicine.

[18]  L. Paulozzi,et al.  Opioid analgesics and rates of fatal drug poisoning in the United States. , 2006, American journal of preventive medicine.

[19]  Daniel W Webster,et al.  Effect of Florida's Prescription Drug Monitoring Program and Pill Mill Laws on Opioid Prescribing and Use. , 2015, JAMA internal medicine.

[20]  Leonard J Paulozzi,et al.  Patterns of abuse among unintentional pharmaceutical overdose fatalities. , 2008, JAMA.

[21]  Leonard J Paulozzi,et al.  Prescription drug monitoring programs and death rates from drug overdose. , 2011, Pain medicine.

[22]  Karin A Mack,et al.  Pharmaceutical overdose deaths, United States, 2010. , 2013, JAMA.

[23]  Kelly Cho,et al.  Prescription opioid duration of action and the risk of unintentional overdose among patients receiving opioid therapy. , 2015, JAMA internal medicine.

[24]  L. Paulozzi,et al.  Decline in Drug Overdose Deaths After State Policy Changes — Florida, 2010–2012 , 2014, MMWR. Morbidity and mortality weekly report.