How Can Prescription Monitoring Programs Prevent Overdose?: A national survey of Prescription Monitoring and Injury Prevention Program Coordinators

Background: Prescription monitoring programs (PMPs) can influence risks to patients associated with abuseable medications, especially prescription opioids.  The extent to which PMPs incorporate overdose prevention—explicitly or implicitly—in their goals, educational materials, and future applications is unknown.

Methods: Telephone interviews were conducted with PMP coordinators/directors and injury prevention or other public health program coordinators in states without active PMPs, whose PMP did not participate in the interview, or as supplemental data.  Interviews sought to enumerate existing efforts and future possibilities in PMP user training, public health impacts, and, specifically, prescription opioid overdose prevention.  Descriptive statistics and content synthesis methods summarized findings from closed and open-ended questions, respectively.

Results:  Interviews with 45 PMP coordinators/directors (44 of 45 active PMP programs) and 14 injury prevention coordinators indicated that ‘preventing overdose’ ranked third among named intended outcomes of the state PMP programs, above law enforcement use (fifth).  Although 97% of PMPs reported having educational materials for providers, 48% addressed interpreting the PMP report, and 24% provided information about responding to an unsolicited report of aberrant medication use.  19 PMPs directly addressed overdose or its prevention on their publicly available PMP website, primarily as justification for PMP existence (n=12) rather than in educational materials (n=3).  Innovative practices of PMP-based overdose prevention included PMP-embedded morphine equivalent daily dose calculators and drug treatment locators.

Conclusions: PMPs could be leveraged for large-scale opioid overdose prevention efforts, and examples from several states provide initial learning examples.  Future work should evaluate impacts of targeted, overdose prevention efforts undertaken with PMPs.