Prescription drug monitoring programs, nonmedical use of prescription drugs, and heroin use: Evidence from the National Survey of Drug Use and Health

Abstract

In the United States, nonmedical prescription opioid use is a major public health concern. Various policy initiatives have been undertaken to tackle this crisis, including state prescription drug monitoring programs (PDMPs). This study uses the 2004-2014 National Survey of Drug Use and Health (NSDUH) and exploits state-level variation in the timing of PDMP implementation and PDMP characteristics to investigate whether PDMPs are associated with a reduction in prescription opioid misuse or whether they have the unintended consequence of increasing heroin use. In addition, the study examines the impact of PDMPs on the availability of opioids from various sources. The study finds no effect of PDMP status on various measures of nonmedical prescription opioid use (abuse, dependence, and initiation), but finds evidence of a reduction in the number of days of opioid misuse in the past year. The study also finds that implementation of PDMP was not associated with an increase in heroin use or initiation, but was associated with an increase in number of days of heroin use in the past year. Findings also suggest that PDMPs were associated with a significant decline in doctor shopping among individuals without increasing reliance on illegal sources (e.g., drug dealers, stealing, etc.) or social sources (friends or relatives) as a means of obtaining opioids. The President's FY2017 budget proposed the allocation of $1.1 billion in an effort to reduce prescription drug misuse, and highlighted the use of PDMPs as a policy tool. This study documents evidence that PDMPs might be having measurable impact.

Medical marijuana and workers' compensation claiming

“…We code the laws as of January 1 of each year. is a vector of time‐varying state‐level characteristics: an indicator for a border state with an MML, decriminalization of marijuana for recreational use, a prescription drug monitoring program, naloxone access and good Samaritan laws (the former provides access to the medication whereas the latter provides legal protection for a person reporting an overdose, thus the combination of the two laws is salient), a pain clinic management law, political party of the governor, poverty rate, unemployment rate, minimum wage, state‐to‐federal earned income tax credit ratio, and population (Pacula, Chriqui, & King, ; Ali, Dowd, Classen, Mutter, & Novak, ; University of Kentucky Center for Poverty Research, ; Prescription Drug Abuse Policy System, ). is a vector of individual‐level variables: age, sex, race, ethnicity, and education.…”

Cancer pain management and the opioid crisis in America: How to preserve hard‐earned gains in improving the quality of cancer pain management

“…This information clarifies whether patients are obtaining opioids or other controlled substances from multiple prescribers and can also be helpful when patients do not recall the dose, last fill date, or other vital data needed to guide future prescribing. Use of these programs has been shown to reduce nonmedical use of opioids and is generally considered to be an essential component of best practices …”

Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse

“…A reduction in sales does not mean a reduction in diversion and misuse if the prescription beneficiary reduces his own consumption but not the amount diverted to others. Substance abuse admissions directly related to Rx drugs also provide an objective counterpart to recent evidence based on self‐reported survey data (Ali et al., ). Third, we check the robustness of the results across different outcomes, specifically mortality and sales of prescription drugs.…”