title: Prescription opioid usage and abuse relationships: an evaluation of state prescription drug monitoring program efficacy.
abstract: BACKGROUND
  The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking.
  
  
  OBJECTIVE
  To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs) on prescription opioid abuse admissions.
  
  
  METHODS
  A RETROSPECTIVE ECOLOGICAL COHORT STUDY COMPARING STATE PRESCRIPTION OPIOID SHIPMENTS (SOURCE: Automation of Reports and Consolidated Orders Systems database) and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set) in 14 states with PDMPs (intervention group) and 36 states without PDMPs (control group) for the period 1997-2003.
  
  
  RESULTS
  From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p < 0.001). PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063). A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764-0.785).
  
  
  CONCLUSIONS
  PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible "chilling effect" on physician prescribing.
authors.affiliation: Gwinnett Hospital System Pain Management Center, Lawrenceville, GA, U.S.A.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Reisman
authors.affiliation: School of Medicine, Emory University, Atlanta, GA, U.S.A.
authors.forename: Pareen J
authors.initials: PJ
authors.lastname: Shenoy
authors.affiliation: Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, U.S.A.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Atherly
authors.affiliation: School of Medicine, Emory University, Atlanta, GA, U.S.A.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Flowers
keywords: PDMP; prescription opioids; substance abuse