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Mandatory Use of Prescription Drug Monitoring Programs

Rebecca L. Haffajee, JD, MPH1; Anupam B. Jena, MD, PhD2,3,4; Scott G. Weiner, MD, MPH5
[+] Author Affiliations
1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
2Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
3Massachusetts General Hospital, Boston
4National Bureau of Economic Research, Cambridge, Massachusetts
5Division of Health Policy Research Translation, Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA. 2015;313(9):891-892. doi:10.1001/jama.2014.18514.
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This Viewpoint describes the benefits of, evidence behind, and prescriber concerns with mandates, and recommends policies that may increase effective use of prescription drug monitoring programs.

The United States is in the midst of a prescription opioid overdose and abuse epidemic. The rate of fatal prescription drug overdoses involving opioids almost quadrupled from 1.4 deaths/100 000 people in 1999 to 5.4 deaths/100 000 people in 2011.1 The rate of emergency department visits involving prescription drug misuse—primarily of opioid, antianxiety, and insomnia medications—more than doubled from 214 visits/100 000 people in 2004 to 458 visits/100 000 people in 2011.2 Forty-nine states have responded by developing prescription drug monitoring programs (PDMPs), which digitally store controlled substance dispensing information and make those data accessible to prescribers, pharmacies, and law enforcement officials. Although PDMPs are designed to curb opioid overprescribing, prescriber utilization is low. The median PDMP registration rate among licensed prescribers who issue at least 1 controlled substance prescription is 35%.3 Furthermore, not all enrolled prescribers regularly use PDMPs.

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