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Editorials |5 June 2018

Prescription Drug Monitoring Programs: Promising Practices in Need of Refinement

Wilson M. Compton, MD, MPE; Eric M. Wargo, PhD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
This article was published at Annals.org on 8 May 2018.
  • National Institute on Drug Abuse, Bethesda, Maryland (W.M.C., E.M.W.)

    Disclaimer: The opinions expressed in this commentary are those of the authors and do not necessarily reflect the views of the National Institute on Drug Abuse, the National Institutes of Health, or the U.S. Department of Health and Human Services.

    Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0883.

    Requests for Single Reprints: Wilson M. Compton, MD, MPE, 6001 Executive Boulevard, MSC 9581, Bethesda, MD 20892; e-mail, wcompton@nida.nih.gov.

    Current Author Addresses: Dr. Compton: 6001 Executive Boulevard, MSC 9581, Bethesda, MD 20892.

    Dr. Wargo: National Institute on Drug Abuse, 6001 Executive Boulevard, Bethesda, MD 20892.

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Although recent data indicate that overdose deaths involving illicit opioids (including heroin and, especially, synthetic opioids, such as fentanyl and related compounds) have escalated in the past 3 years, widespread overprescription, diversion, and misuse of opioid analgesics started the crisis (1). Prescription opioids remain a major contributor to overdose deaths and serve as an entry point for many persons to become addicted to opioids, even if they switch to illicit opioids later because of lower cost and progression of their opioid use disorder (2–4).
Implementation of prescription drug monitoring programs (PDMPs) has been among the many policy-level efforts to curb irresponsible prescribing and diversion of opioids. The expectation is that providing clinicians with PDMP data on other medications their patients may be receiving will change their prescribing practices. In some jurisdictions, law enforcement may use these data to identify potentially illegal prescribing activity. However, although PDMPs now exist in all states and the District of Columbia, their implementation varies greatly. In addition, research assessing the effect of PDMPs on opioid misuse, diversion, and overdose has been sparse. Thus, the systematic review by Fink and colleagues (5) on the association between PDMPs and overdoses is a welcome contribution.
Fink and colleagues reviewed studies addressing the relationship between PDMPs and nonfatal and fatal overdoses and attempted to clarify the program features that might be most effective. The great diversity of PDMPs makes such an analysis challenging, and the authors acknowledge that the observational nature of all...
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Compton WM, Wargo EM. Prescription Drug Monitoring Programs: Promising Practices in Need of Refinement. Ann Intern Med. [Epub ahead of print 8 May 2018]168:826–827. doi: 10.7326/M18-0883

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Published: Ann Intern Med. 2018;168(11):826-827.

DOI: 10.7326/M18-0883

Published at www.annals.org on 8 May 2018

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