Opioid Abuse: State Prescription Drug Monitoring Programs Help Reduce Overdose Death Rates

In 2015, the director of the National Institute on Drug Abuse, Dr. Nora Volkow, “told a group of Kentucky journalists and others at the Foundation for a Healthy Kentucky Health Journalism Workshop” that it is “possible to decrease the over-prescription of opioids, but” she said, “the solutions aren’t ‘sexy.’”

For example, to address the opioid epidemic in the U.S., some states have implemented policies to curb inappropriate opioid prescribing. These policies include, for example: mandatory provider use of prescription drug monitoring programs (PDMPs), and pain clinic laws that feature requirements such as registration of pain clinics with the state, physician ownership of the clinics, prescribing restrictions, and record-keeping requirements.

A recent study published in Health Affairs found that “combined implementation of mandated provider review of state-run prescription drug monitoring program data and pain clinic laws reduced opioid amounts prescribed by 8 percent and prescription opioid overdose death rates by 12 percent.”

The study results “suggest that some opioid prescribing policies had intended effects on opioid prescribing and overdose death rates.”
“We found that mandated review of prescription drug monitoring program data combined with pain clinic laws was significantly associated with both decreased amounts of opioids prescribed and with decreased prescription opioid overdose deaths,” the authors state.

As for potential effects of these policies on heroin overdose death rates, the study notes that “publications in mainstream media and in the scientific literature have advanced the idea that opioid prescribing policies have unintentionally driven demand for heroin (a drug with similar effects) as people search for ‘a cheaper, more accessible high.’” However, the study “did not find any evidence to support the concern that these opioid prescribing policies result in increased heroin-related overdose deaths. However, additional factors, including increased heroin supply, a population already widely exposed to prescription opioids, and increased mixing of highly potent illicitly manufactured fentanyl with heroin, are likely to continue to pose daunting challenges to the prevention of heroin overdose deaths.”

“This combination of policies was effective, but broader approaches to address these coincident epidemics are needed,” said Deborah Dowell, senior medical advisor at the Centers for Disease Control & Prevention’s (CDC) National Center for Injury Prevention and Control.

One step forward is better than none, boring and unsexy as those solutions might be.