Prescription Drug Monitoring Programs and Opioid-Related Overdose Deaths
*Names in bold indicate Presenter
Over the last decade the number of opioid pain relievers (OPR) sold in the US quadrupled. The rise in OPR sales was accompanied by serious complications, including accidental overdose deaths. In response, many state governments created prescription drug monitoring programs (PDMPs) as a tool to detect high-risk prescribing. Our objective was to determine if PDMP implementation is associated with a decrease in opioid-related overdose deaths.
We obtained data from multiple public sources to evaluate the association of PDMP implementation with opioid-related death for a sample of 33 states that implemented a PDMP between 1999 and 2013. We accounted for time and state-level confounders by using an interrupted time series approach; we also utilized this modeling strategy to investigate the association of PDMP characteristics, such as frequency of updating and number of drug schedules monitored, with opioid-related deaths.
Results: From 1999 to 2013, the number of states with a PDMP increased from 15 to 48. Over the same period, opioid-related deaths for states in our sample grew from 1.4 to 5.7 per 100,000 US adults per year. In adjusted analyses we found that state PDMP implementation was associated with a mean decrease in opioid-related overdose deaths of 0.70 (95%CI 0.31-1.10) per 100,000 adults per year and that more frequent reporting to PDMPs (0.82; 95% CI 0.38-1.25) and monitoring more schedules of drugs (0.55; 95% CI 0.08-1.02) was associated with greater reductions. If every state updated its PDMP to monitor four or more schedules of drugs and report data to the PDMP weekly or more frequently, the opioid-related death rate would decline by 0.43 per 100,000, preventing one death every 6 hours in 2016.
Conclusion: After adjusting for potential confounders, state PDMP implementation is associated with a decrease in opioid-related overdose death. Well-designed PDMPs may be effective tools for states to reduce the number of opioid-related overdose deaths and play an important role in controlling the OPR epidemic.