Association for Public Policy Analysis & Management

Over the past two decades, the number of opioid pain relievers (OPRs) sold in the US grew dramatically. The rise in OPR sales was accompanied by an increase in opioid-related overdose deaths. In response, 49 states created prescription drug monitoring programs (PDMPs) to detect high-risk prescribing and patient behaviors. Our objectives were to determine if PDMP implementation or particular PDMP characteristics were effective in reducing opioid-related overdose deaths. In adjusted analyses, we found that state PDMP implementation was associated with an average reduction of 1.12 (95%CI 0.55-1.68) opioid- related overdose deaths per 100,000 adults annually after implementation. Additionally, states with robust PDMP characteristics - including monitoring four or more drug schedules with abuse potential and updating their data at least weekly - had greater reductions compared to states without these features. We estimate that if Missouri adopted a PDMP and 23 other states enhanced their PDMP with robust features, there would be more than 600 fewer overdose deaths nationwide in 2016, preventing approximately two deaths each day.