Characteristics of Prescription Monitoring Programs: A Quantitative Legal Analysis

Nonmedical use of prescription drugs is a large and growing public health problem in the US. The number of overdose deaths has risen five-fold since 1990, with more overdose deaths than motor vehicle fatalities in the US every year. The majority of overdose deaths are due to prescription opioid pain medications.

Electronic databases known as prescription monitoring programs (PMPs) are intended to reduce misuse of prescription drugs and associated harms by tracking the dispensing of controlled substances and making those data available to medical professionals and, in some circumstances, law enforcement officials. As of February 2012, every state has an operational PMP or pending authorizing legislation.

PMPs vary greatly in their operational characteristics, including data access policies, which drugs are monitored and which providers, if any, are required to use the program. This variation can lead to difficulty in evaluating the effectiveness of these programs as well as confusion among clinicians and patients. We conducted a state-by-state review of PMP statutes, regulations and case law, using a quantitative legal research framework. Starting with a standardized search protocol, retrieved laws were reviewed and coded in duplicate to ensure consistency. In this session, we present results of the systematic evaluation of laws relevant to the operation of PMPs in all 50 states, DC and Puerto Rico. Our results suggest that differences between PMP operations may in part impact how effective they are in reducing overdose deaths.