Longitudinal legal assessment and analysis of prescription monitoring programs

Drug overdose is now the leading cause of accidental injury death in the United States, claiming more lives each year than automobile accidents. This large and growing epidemic is largely caused by a dramatic increase in overdose caused by prescription opioid pain medications. In part to counter this trend, almost all states have passed laws creating prescription monitoring programs (PMPs), centralized electronic databases that collect data on the prescribing and dispensing of prescription opioids and other controlled substances.

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. In addition, many laws and regulations governing PMP operation have changed significantly over time. Therefore, any attempt to assess the effectiveness of PMP laws requires cataloguing the specific statutory provisions within each state across time. We conducted a review of all state PMP laws between January 1, 1998 and December 31, 2011 and coded changes across time with respect to over 40 operational characteristics. Using a standardized research protocol, relevant laws were gathered for each state, and any changes during the study period were noted. All relevant laws were then coded in duplicate. Finally, the state of each state PMP across each variable for each month of the study period was entered into LawAtlas. Results of the legal analysis were then used to determine whether differences between PMP operations may in part impact if and how effective they are in reducing overdose deaths.