Prescription Drug Monitoring Programs (PDMPs)

PDMPsRecently, CNN’s Chief Medical Correspondent Dr. Sanjay Gupta wrote and published an op-ed to coincide with a special report about prescription opioids. Dr. Gupta covered a number of different aspects about the state of the American opioid epidemic and expounded on how the situation became so dire. Perhaps the most interesting aspect about the article was Gupta essentially holding doctors responsible for the market share of the crisis and calling on physicians to do their part to reverse the damage. It is important to keep in mind that there are several different factors that led to the emergence of an epidemic, and while doctors did and continue to overprescribe opioid narcotics, a multifaceted approach from lawmakers, addiction experts and doctors is essential for ending the scourge that claims over 70 lives in this country every day. It is widely accepted that Americans, enabled by doctors, have become far too reliant on prescription opioids—even for pain that could be treated by opioid alternatives. What’s more, while the the vast majority of prescription opioids are written by primary care physicians, few doctors have any opioid prescribing practices training or knowledge about addiction. On top of that, there has not been a huge push from medical organizations urging doctors to acquire the requisite training. Even the American Medical Association (AMA) is resistant to having doctors trained to prescribe responsibly. Hopefully, in the near future doctors will heed the call from Gupta to be a part of the solution, rather than part of the problem. When discussing the American opioid epidemic, the conversation typically is about how bad it is; however, it is important that we take a moment to recognize the strides that have been made in the right direction.

PDMPs

Several years ago, amidst widespread overprescribing by pain management clinics—otherwise known as “pill mills”—and rampant “doctor shopping,” the act of going to multiple doctors in a month to double and triple up on one’s prescription opioids, states began to implement what are known as prescription drug monitoring programs (PDMPs). The programs were designed to give doctors a resource for identifying doctor shoppers and to give authorities a window into which doctors are prescribing suspiciously. PDMPs were met with resistance by some doctors, and to this day there is a significant number of them who do not utilize the resource; but, drug monitoring programs have proved to be an invaluable resource. Today, 49 states have adopted a PDMP of some kind, and there is now evidence that suggests the programs are having the desired effect. In fact, new research from Weill Cornell Medical College has found that, in the states that have implemented a PDMP, a 30 percent decrease in prescriptions for opioids and other narcotics could be seen, NBC News reports. The findings were published in the journal Health Affairs.
This reduction was seen immediately following the launch of the program and was maintained in the second and third years afterward,” writes researcher Yuhua Bao and colleagues. "Our analysis indicated that the implementation of a prescription drug monitoring program was associated with a reduction in the prescribing of Schedule II opioids, opioids of any kind, and pain medication overall.”

Uncertain Conclusions

The news is without a doubt a breath of fresh air, yet in the wake of the death of pop superstar Prince—clearly we as a nation have a long way to go. The research team believes that there could be a number of reasons for the PDMP success. The 30 percent drop in written prescriptions, according to researchers could be that PDMPs:
  • Raised awareness about opioid abuse with doctors.
  • Made doctors more cautious about writing prescriptions that can lead to dependence and addiction.
  • Caused doctors to cut back on prescriptions knowing that they were being watched.
Regardless of the reason for PDMPs causing a reduction, they have had a notable impact which indicates that efforts to curb the problem have had some success. Before PDMPs 5.5 percent of doctor’s visits involving pain management resulted in a prescription for an opioid being written, after drug monitoring programs that number fell to 3.7 percent.

Addiction Treatment

Cutting back on the number of prescriptions written is paramount, unfortunately opioid addicts who struggle to get their pills will more times than not turn to heroin as an alternative. Simply making it harder to get drugs doesn't mean that people will be free of addiction. It cannot be stressed enough just how vital addiction treatment services are to ending the epidemic in the U.S. At PACE Recovery Center, our qualified staff can assist you or a loved one in ending the cycle of addiction. We can show you how it is possible to live a healthy, productive life free from drugs and alcohol. Please contact PACE to begin the life changing journey of addiction recovery.

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