Prescription Drug Monitoring Programs Reduced Number of Opioid Prescriptions

Opioid prescription overdoses accounted for nearly 19,000 deaths in 2014, for which 10 million individuals reported to have been taking opioids non-medically. However, prescription drug monitoring programs have been associated with a decreased number of written prescriptions for the highly-addictive and most recently abused drug.

A study led by Yuhua Bao, PhD, associate professor of healthcare policy and research at Weill Cornell Medical College, and published in Health Affairs found that prescription drug monitoring programs were associated with a more than 30% reduction in the rate of prescribing Schedule II opioid analgesics. The decrease in prescriptions occurred immediately following provider and physician access to this program and was sustained in the second and third years after implementation.

Prescription drug monitoring programs are statewide databases that are used to gather information from the pharmacies on dispensed prescriptions for controlled substances. These programs were adopted in response to the recent opioid epidemic, where users are either “doctor shopping” for the medication, going to multiple physicians for multiple prescriptions, or from family or friends who have been prescribed the medication.

The study examined data collected from The National Ambulatory Medical Care Survey (NAMCS), which asked a systematic sample of physicians and clinicians to complete the annual survey for about 30 visits that occurred during a randomly selected 1-week time frame and is run by the National Center for Health Statistics. The survey asked respondents to fill in key information about the patient, clinician, and practice, and aimed to discover the “why” behind the visit. Surveyors are asked about the reasons behind a patient’s visit, the diagnoses pertaining to the specific visit and information regarding the medications prescribed during this visit.

Bao and her research team scanned data collected from this survey between 2000 and 2010 for patients ages 18 or older and who reported pain as one of the reasons for the office visit. The team filtered the office visits to one of the 24 states that implemented a prescription drug monitoring program within the study time frame as well as to the cases having been prescribed at least one Schedule II opioid analgesic and having at least one opioid of any kind prescribed or continued at a pain-related ambulatory care visit. The Schedule II opioid is the category with the highest potential for abuse.

Of the nearly 26,000 office visits examined, 5% resulted in at least 1 prescription for Schedule II opioids, 15% in at least 1 opioid analgesic of any kind, 41% in any pain medication, and 24% in at least one non-opioid analgesic. Additionally, the research team discovered significant reductions in each of the drugs specifically, where Schedule II opioid prescriptions decreased by 2.1 percentage points within the first 6 months of program implementation as well as significant decreases in the following 2 years.

Not only did the implementation of these prescription drug monitoring programs allow all participating prescribers, pharmacists, law enforcement agencies, and medical licensure boards to keep an eye on this issue, but the authors also believed it helped shed light on the sheer amount of opioid prescriptions being written.

“It is possible that the implementation of a prescription drug monitoring program by itself substantially raised awareness among prescribers about controlled substance misuse and abuse and made them more cautious when prescribing pain medications with a great potential for abuse and dependency,” the authors wrote.