Prescription drug monitoring programs (PDMPs) are valuable tools in mitigating the abuse and diversion of prescription controlled substances from legitimate medical use to illicit use. Drug monitoring programs, the procedures and powers of which can vary significantly from state to state, all share a similar strategy: to require doctors, pharmacists or both to enter all prescriptions into a database that can — or, in some states, must — be consulted later to make sure patients do not get excess medication.

Forty-nine states use some form of PDMPs and many are working on improvements or changes to prevent abuse, with Missouri the only holdout. The goal is to require doctors to check databases before prescribing opioid drugs to prevent and recognize patients that may be abusing or doctor shopping, along with requiring pharmacists to monitor patients and the doctors who may be overprescribing addictive medications.

The prescribing of opioid painkillers parallels the dramatic increase in numbers of deaths, emergency room visits, and treatment episodes attributable to non-medical use of controlled substances. Health care systems and facilities are responsible for and committed to quality improvement and the safety of their patients, although prescription drug abuse has continued to rise in the United States over the last 15 years.

Consider the evidence:

  1. Deaths from unintentional drug overdoses continue to rise, surpassing motor vehicle fatalities asthe leading cause of accidental death. 
  2. Emergency department visits due to misuse of controlled substances now substantially outnumber those for illicit drugs such as heroin and cocaine.
  3. Treatment admissions for prescription opioids have more than doubled in the last decade.
  4. The costs stemming from the non-medical use of prescription opioids in lost productivity, law enforcement, drug abuse treatment, and medical complications; estimated at over $50 billion annually.

The Prescription Drug Monitoring Program (PDMP) Center of Excellence was founded to combat the prescription drug abuse epidemic. The expertise, experience and commitment of the Center make it a unique resource in the fight against prescription drug abuse. The Center draws from the recommendations of 77 nationally recognized experts in addiction treatment, pain medication management, public health and epidemiology. The Center of Excellence has issued a groundbreaking report recommending that medical insurers use prescription-monitoring data to reduce overdoses, deaths and health care costs associated with abuse of opioids and other prescription drugs.

The medical objective of provider interventions is to refer patients to substance abuse treatment rather than law enforcement. There is a continuing need for studies to determine the best practices on prescriber education, use of PDMPs, clinical response if addiction or abuse is determined, privacy legislation, and data sharing contracts between states with differing PDMP programs. More can be done to make PDMPs more successful in the future to combat increasing drug abuse and help the individual find solutions to their suffering.