Every State Now Has a Prescription Drug Monitoring Program
Recently, Missouri implemented its own Prescription Drug Monitoring Program (PDMP) to help medical care providers spot the potential misuse of pharmaceutical drugs among their patients. Now that Missouri created its own PDMP, all 50 U.S. states have such programs. This is good news because PDMPs are useful preventive tools for reducing doctor shopping. They also help doctors make more accurate and safer decisions about who to prescribe pills to and what to prescribe.
It’s worth recognizing the value that PDMPs bring in the form of preventing drug abuse. But at the same time, PDMPs are just one side of what must ultimately be a multi-faceted approach to tackling addiction in the United States.
What are Prescription Drug Monitoring Programs?
From the Centers for Disease Control and Prevention, “A prescription drug monitoring program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate a nimble and targeted response.” PDMPS are implemented to improve opioid prescribing, better inform clinical practitioners, and protect patients at risk. When states implement PDMPs, they result in more conservative prescribing behavior on the part of physicians, a reduction in patients using multiple providers to get pills, and opportunities for physicians to recognize that the patient in front of them is addicted to drugs, providing them with an opportunity to refer that patient to substance abuse treatment.
“PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate a nimble and targeted response.”
To summarize, Prescription Drug Monitoring Programs create a paper trail, tracking which patients get what prescription painkillers, and from which doctor. If a patient sees multiple doctors for the same painkiller, that raises a red flag and indicates the patient may be misusing their medications. This gives doctors the chance to intervene on that patient’s behavior and instead refer them to treatment, not simply continue to supply their addiction.
As one nurse practitioner organization put it, “The prescription history provided by these databases may serve as an important piece of state and national strategies to curb America’s growing drug abuse problem. As PDMPs provide a record of filled prescriptions, these tools may offer a more detailed and accurate history than what a patient may self-report. Prescribers using these systems have an opportunity to gain a more comprehensive assessment of medication use and make more informed decisions regarding what and whether to prescribe.” For the most part, medical experts, policymakers, and addiction treatment professionals agree that PDMPs are a useful tool in combatting America’s growing opioid epidemic.
Thanks to Missouri’s Decision, Every State Now Has a PDMP
After intense pressure from local activists and public health officials, Missouri lawmakers agreed to create a Prescription Drug Monitoring Program for the state’s health department. The program will now make it much more difficult for addicts to doctor shop, and it will help prevent doctors from overprescribing.
Missouri’s new program strongly encourages doctors to check the PDMP database before writing prescriptions for their patients, though participation in the program is not mandatory. However, when doctors do use the PDMP, doing so will help show them if the patient in front of them has seen other doctors for the same requested meds (doctor shopping). It will also give the prescribing doctor insight into the patient’s medical history and what may or may not be appropriate to prescribe them.
Missouri has already seen success with PDMPs on a county level. For example, St. Louis County implemented its own program in 2017. Once implemented, opioid prescriptions in St. Louis County decreased dramatically. In 2016, the county averaged 80.4 opioid prescriptions per 100 people. But in 2019, two years after implementing the PDMP, it was down to 58.3 prescriptions per 100 people.
While Missouri’s new PDMP implementation decision is not without criticism (some worry that making doctors more capable in preventing doctor shopping will force addicts to seek illicit street drugs such as heroin or fentanyl), most Missouri public health experts feel this is a step in the right direction. Like doctors in all other 49 U.S. states, Missouri physicians now have a tool for determining if the patient in front of them is in genuine pain and needs relief or is simply an addict seeking a prescription. With that knowledge, Missouri practitioners can refer addicts to treatment, not unknowingly supply them with their next fix.
The Scope of Opioid Addiction in the U.S.; Why PDMPs are Critical
According to the National Institute on Drug Abuse, about 15,000 Americans die from overdosing on prescription pain relievers every year. The death toll shot up during the early and mid-2000s and then leveled out in the 2010s. Prescription opioid overdose deaths rose from 3,442 fatalities in 1999 and peaked at 17,029 deaths in 2017. But with the nationwide implementation of PDMPs, medical practitioners can do their part to help prevent future deaths.
The opioid epidemic has undoubtedly been one of America’s worst addiction crises, hence the urgency to use every tool available to combat it. The CDC reports that about 841,000 Americans died from drug overdoses between 1999 and 2019, with the majority of those deaths involving an opioid. In fact, since 1999, the CDC estimated that opioid-related deaths skyrocketed by over 600%.
The CDC also reported that 2020 was the worst year yet for drug overdoses in which about 93,000 Americans died from overdoses, a shocking 30% increase from the previous year. Now more than ever, the nation needs all of the tools it can get for combatting the fatal addiction epidemic.
Of course, PDMPs are not a foolproof tool that will singlehandedly fix the opioid crisis. In fact, PDMPs only close one of many avenues that addicts have to get drugs. That’s why treatment is so important for addressing America’s drug problem.
Addiction Treatment is the Solution to America’s Opioid Epidemic
PDMPs help the American people tackle the addiction crisis because they prevent the diversion of prescription painkillers from doctors to addicts who are masquerading as pain patients. But PDMPs aren’t themselves a solution to addiction. Treatment is.
If you know someone who is addicted to opioid painkillers, someone who is hooked on any type of drug for that matter, someone who cannot stop using mind-altering substances, please reach out to a qualified drug and alcohol treatment center as soon as possible.
Please don’t wait until it is too late to help your loved one. Reach out to a drug addiction treatment center today. Doing so can be lifesaving.
Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP, LCDC