title: Implementation Of Prescription Drug Monitoring Programs Associated With Reductions In Opioid-Related Death Rates.
abstract: 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.
authors.affiliation: Stephen W. Patrick (stephen.patrick@vanderbilt.edu) is an assistant professor of pediatrics and health policy, Division of Neonatology, at Vanderbilt University School of Medicine, in Nashville, Tennessee.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Patrick
authors.affiliation: Carrie E. Fry is a health policy and data analyst in the Department of Health Policy at Vanderbilt University School of Medicine.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Fry
authors.affiliation: Timothy F. Jones is the state epidemiologist for the Tennessee Department of Health, in Nashville.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Jones
authors.affiliation: Melinda B. Buntin is professor and chair of the Department of Health Policy at Vanderbilt University Medical Center, in Nashville.
authors.forename: Melinda B
authors.initials: MB
authors.lastname: Buntin
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D059350:Chronic Pain / Q000188:drug therapy / Q000503:physiopathology; D015331:Cohort Studies; D016208:Databases, Factual; D016903:Drug Monitoring / Q000379:methods* / Q000401:mortality; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000401:mortality* / Q000517:prevention & control*; D018570:Risk Assessment; D016019:Survival Analysis; D014481:United States
chemical_list: D000701:Analgesics, Opioid
keywords: Epidemiology; Health Promotion/Disease Prevention; Mental Health/Substance Abuse; Pharmaceuticals; Public Health