title: Prescription drug monitoring and drug overdose mortality.
abstract: BACKGROUND
  Abuse of prescription drugs, particularly opioid analgesics, has become a major source of injury mortality and morbidity in the United States. To prevent the diversion and misuse of controlled substances, many states have implemented prescription drug monitoring programs (PDMPs). This study assessed the impact of state PDMPs on drug overdose mortality.
  
  
  METHODS
  We analyzed demographic and drug overdose mortality data for state-quarters with and without PDMPs in 50 states and the District of Columbia during 1999-2008, and estimated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) of drug overdose mortality associated with the implementation of state PDMPs through multivariable negative bionomial regression modeling.
  
  
  RESULTS
  During the study period, annual national death rates from drug overdose increased by 96%, from 5.7 deaths per 100,000 population in 1999 to 11.2 in 2008. The impact of PDMPs on drug overdose mortality varied greatly across states, ranging from a 35% decrease in Michigan (aRR = 0.65; 95% CI = 0.54-0.77) to a more than 3-fold increase in Nevada (aRR = 3.37; 95% CI = 2.48-4.59). Overall, implementation of PDMPs was associated with an 11% increase in drug overdose mortality (aRR = 1.11; 95% CI = 1.02-1.21).
  
  
  CONCLUSIONS
  Implementation of PDMPs did not reduce drug overdose mortality in most states through 2008. Program enhancement that facilitates the access and use of prescription drug monitoring data systems by healthcare practitioners is needed.
authors.affiliation: Department of Anesthesiology, Columbia University, 622 West 168th St, PH5-505, New York, NY, 10032, USA. GL2240@cumc.columbia.edu.|Department of Epidemiology, Columbia University, 722 West 168th St, 5th Floor, New York, NY, 10032, USA. GL2240@cumc.columbia.edu.
authors.forename: Guohua
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Columbia University, 622 West 168th St, PH5-505, New York, NY, 10032, USA.|Department of Epidemiology, Columbia University, 722 West 168th St, 5th Floor, New York, NY, 10032, USA.
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Brady
authors.affiliation: Department of Anesthesiology, Columbia University, 622 West 168th St, PH5-505, New York, NY, 10032, USA.
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Lang
authors.affiliation: Department of Emergency Medicine, Columbia University, PH1-137, New York, NY, USA.
authors.forename: James
authors.initials: J
authors.lastname: Giglio
authors.affiliation: Department of Anesthesiology, Columbia University, 622 West 168th St, PH5-505, New York, NY, 10032, USA.|Department of Epidemiology, Columbia University, 722 West 168th St, 5th Floor, New York, NY, 10032, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Wunsch
authors.affiliation: Department of Anesthesiology, Columbia University, 622 West 168th St, PH5-505, New York, NY, 10032, USA.|Department of Epidemiology, Columbia University, 722 West 168th St, 5th Floor, New York, NY, 10032, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: DiMaggio
keywords: Overdose; Policy intervention; Prescription drug