Pushing for the Federal Standardization of Prescription Drug Monitoring Programs

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In 2012, the Centers for Disease Control and Prevention declared prescription drug abuse an epidemic in the United States as the number of unintentional opioid overdoses had increased by 75% since 1999. These trends went hand in hand with increases in opioid prescriptions. In response, 49 states developed Prescription Drug Monitoring Programs (PDMP) to track prescriptions of regulated substances – databases providers can check before writing prescriptions.

PDMPs have become pillars of the national strategy, but their effectiveness varies by state. These differences highlight the main problem: the features of PDMPs including timeliness of data collection, who has access, requirements for use, interstate operability, and mechanisms to enforce prescriber noncompliance, also vary by state. As PDMPs are evaluated, evidence is amassed about the most effective features and must be translated into policy.

Several players including the National Alliance for Model State Drug Laws and the PDMP Training and Technical Assistance Center have synthesized and spread this information without directly proposing federal standardization. The National Council for Prescription Drug Programs issued technical proposals for the application of best practices; and grassroots NGOs such as Shatterproof have worked with individual states to make PDMPs more effective. As efforts spread, the American Medical Association has reacted against the mandatory use of PDMPs by providers, and the ACLU against the violation of patient privacy.

Another avenue should be pursued. More than half the states use federal funds to support their PDMP, the biggest program being the Harold Rogers PDMP Grant administered by the US Department of Justice’s Bureau of Justice Assistance (BJA). Grassroots NGOs should use their visibility to push the BJA to standardize PDMPs by making the most effective features of PDMPs requirements for the receipt of federal funds. The BJA must encourage states to apply evidence rather than turn their back to it.

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