Prescription monitoring programs reduce mortality rates due to overdose

Background: The Centers for Disease Control recommend the implementation of Prescription Monitoring Programs (PMPs) as a way to combat the misuse of prescription medications. Studies have shown that the implementation of PMPs can lead to a decrease in diversion as well as an increase in substance abuse treatment admissions. However, no study to date has examined the effect of PMPs on mortality attributed to prescription drug overdose. Methods: This study used detailed mortality data on deaths which involved prescription medications (n=267,083) that occurred in each state between 1999 and 2008. These data were obtained from the CDC “WONDER” System using ICD-10 codes. Implementation of PMPs was staggered between states, with 24 states implementing PMPs during the study period. Therefore, this analysis uses a difference-in-difference Poisson Generalized Estimating Equation to assess the causal effects of implementing PMPs on the rate of mortality attributed to prescription drug overdoses. To estimate effects on specific subgroups, analyses were stratified by age, race and urbanization status. Results: Across all groups, the implementation of a Prescription Monitoring Program decreased the rate of deaths attributable to prescription medication overdose by 0.4 percent (95% CI: 0.001-0.007). This decrease is much higher, 1.2 percent (95% CI: 0.005-0.018), among people who live in rural areas. No differences in effect were found by age or race. Conclusion: PMPs significantly reduce mortality associated with prescription drug use, particularly among people living in rural areas. If all states had implemented PMPs in 1999, 1,170 deaths would have been prevented between 1999 and 2008.