June 8, 2020
One doesn’t read the CDC’s Morbidity and Mortality Weekly Report (MMMR) expecting good news, but the March 20, 2020 edition provided some: Drug overdose deaths involving prescription opioids had decreased by 13.5% from 2017 to 2018.1 However, the article’s authors are quick to point out that now is not the time for complacency, stating “Efforts related to all opioids, particularly deaths involving synthetic opioids, should be strengthened to sustain and accelerate declines in opioid-involved deaths. Comprehensive surveillance and prevention measures are critical to reducing opioid-involved deaths…”
Prescription Drug Monitoring Plans (PDMPs) are a way state governments implement the public health surveillance required to combat opioid abuse. According to the Prescription Drug Monitoring Program Training and Technical Assistance Center, prescribers in 43 states are now required to enroll in their state PDMPs, and most states require prescribers to check a patient’s PDMP record when prescribing opioids.2
So does this decline in prescription opioid overdoses mean that the PDMP strategy is a proven success? Recent research conclusions around this topic are mixed:
- Grecu3 found that mandatory PDMP use related to a significant reduction in treatment admissions for opioid use disorder. Mandatory is the operative word: just having a PDMP available didn’t seem to change anything.
- Ponnapalli4 concluded that PDMPs helped reduce opioid abuse and overdose, but their lack of usability limited their effectiveness.
- Both Delcher5 and Fink7 point out that increased PDMP use may lead to a decrease in prescription opioid overdoses, but that decrease may be offset with an increase in illicit opioid overdoses. The data from the March MMMR article seems to support this idea, showing a 10% increase in overdose deaths from synthetic opioids, such as illicitly manufactured fentanyl, from 2017 to 2018.
- Rhodes6 recognized that PDMPs don’t directly affect overdose rates, but they play an important role in an overall opioid addiction prevention strategy and reinforce safer opioid prescribing practices.
hc1 Opioid Advisor® expands PDMP effectiveness by integrating PDMP checks with another important monitoring activity: drug testing. hc1’s exclusive partnership with PDMP developer Appriss Health allows us to provide one-click access to complete PDMP reports and drug consistency analysis backed by official PDMP data. hc1 Opioid Advisor® also integrates the dispensing records from multiple states in the single patient report, a feature that can be critically important and convenient to a busy physician office. The easy-to-understand drug consistency reports highlight where test results are inconsistent with dispensed medications. This data can drive discussions between prescribers and patients about compliance to prevent opioid abuse and accidental overdose.
To learn more about hc1 Opioid Advisor®, request a demo.
References and Resources
- Wilson, Nana PhD, et al. (2020 March 20). Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018. Morbidity Mortality Weekly Rep 2020;69:290–297. https://www.cdc.gov/mmwr/volumes/69/wr/mm6911a4.htm
- Prescription Drug Monitoring Program Training and Technical Assistance Center. (Accessed 2020 July 1). Mandated Enrollment and Usage. https://www.pdmpassist.org/Policies/Enrollment
- Grecu, Anca M., et al. (2018 October 15). Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse. Journal of Policy Analysis and Management, Volume 38, Issue 1, Winter 2019. https://doi.org/10.1002/pam.22098
- Ponnapalli, Aditya, et al. (2018 December 5). Systematic Literature Review of Prescription Drug Monitoring Programs. AMIA Annual Symposium Proceedings Archive 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371270/
- Delcher, Chris, et al. (2020 July). Advances in prescription drug monitoring program research: a literature synthesis (June 2018 to December 2019). Current Opinion in Psychiatry: July 2020 – Volume 33 – Issue 4 – p 326-333. https://pubmed.ncbi.nlm.nih.gov/32250984/
- Rhodes, Emily, et al. (2019 November 01). The effectiveness of prescription drug monitoring programs at reducing opioid-related harms and consequences: a systematic review. BMC Health Services Research 19, 784 (2019). https://doi.org/10.1186/s12913-019-4642-8
- Fink, David S., et al. (2018 June 5). Association Between Prescription Drug Monitoring Programs and Nonfatal and Fatal Drug Overdoses: A Systematic Review. Annals of Internal Medicine. https://doi.org/10.7326/M17-3074