Has Prescription Monitoring Curbed the Opioid Epidemic?

Mandates designed to decrease opioid prescriptions in the U.S. have worked, but they also have had an unintended public health outcome, according to a study published July 2, 2022, in Production and Operations Management that focused on mandated use of Prescription Drug Monitoring Programs (PDMPs).

Many states have implemented policies that require prescribers to check a patient’s prescription history prior to initiating or refilling prescriptions for controlled substances. Dr. Tongil “TI” Kim, assistant professor of marketing in the Naveen Jindal School of Management, found that in states that mandated PDMPs, opioid prescriptions decreased. The mandates, however, had the unintended effect of driving existing opioid users toward more lethal, illicit substitutes, such as heroin.

The study focused on the time during the early deployment of mandated PDMPs, when 19 states required prescribers to check the system before prescribing controlled substances.

The researchers constructed a national data set that included information on opioid prescribing and incidences of opioid deaths from all U.S. states between 2006 and 2015. The analysis found that implementing PDMPs decreased prescriptions 6.1%, though the researchers determined the policy did not reduce deaths due to prescription opioids. Additionally, heroin-related deaths increased 50.1% under PDMP mandates.

Kim speculates that placing supply restrictions on prescription opioids might have led patients to seek dangerous alternatives. They also found that areas with low availability of heroin and high capacity for opioid-use disorder treatment facilities did not experience significant substitution to heroin under mandated PDMPs.

– Brittany Magelssen