Overdose deaths from prescription opioids in the U.S. quadrupled from 1999 to 2015, reaching 22,000 in 2015. This increase has been fueled by a dramatic rise in the amount of opioids being prescribed, creating a vast supply of drugs at high risk for misuse. Prescribers, therefore, are a vital link in addressing the current epidemic of overdose deaths and substance use disorders. The challenge is to develop and implement systems that help prescribers identify potential cases of misuse or diversion, while still allowing appropriate prescribing of opioids for pain control. All states except Missouri now have functioning prescription drug monitoring programs (PDMPs) that collect data from pharmacies on all dispensed controlled substances. These statewide databases have many potential uses: they can help prescribers identify patients who are "doctor-shopping" or who might need substance use disorder treatment; they can help government agencies and medical licensure boards monitor prescribing practices and identify unusual prescribing patterns; and they can inform community-based prevention strategies. For a PDMP to be effective, however, it must be used. Despite the promise of PDMPs, actual use of PDMPs by prescribers remained low until recent years. A 2014 national survey found that 72 percent of primary care physicians were aware of their state's PDMP, but only 53 percent of primary care physicians ever used it, and many did not use it routinely. Since then, some states have implemented mandates for provider participation in PDMPs. This Issue Brief reviews the current status and characteristics of PDMPs, their use, and evidence of their effectiveness. It summarizes best practices for PDMPs and the needs for further research and evaluation.
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