Interstate Information Sharing and Interoperability
State PDMPs vary widely with respect to whether or how information contained in the database is shared with other states. While some states do not have measures in place allowing interstate sharing of information, others have specific practices for sharing. These practices may be based on factors such as agreed-upon reciprocity between states, or whether a request stems from an ongoing investigation. As of December 2013, 45 states allowed for sharing PDMP information on some level—with PDMPs in other states, with authorized PDMP users in other states, or both…
Potential Unintended Consequences
PDMPs may have unintended consequences beyond reducing prescription drug diversion and abuse. Prescribers may hesitate to prescribe medications monitored by the PDMP—even for appropriate medical use—if they are concerned about potentially coming under scrutiny from law enforcement or licensing authorities. Studies of paper-based prescription monitoring programs that preceded the electronic PDMPs found that many prescribers did not order the required prescription forms, rendering them unable to prescribe specified controlled substances at all. Their concerns may lead prescribers to replace medications that are monitored by the PDMP with medications that are not monitored by the PDMP, even if the unmonitored medications are inferior in terms of effectiveness or side effects. Studies showed that after benzodiazepines were added to New York’s paper-based program in 1989, a decrease in benzodiazepine prescriptions was accompanied by an increase in prescriptions for other sedatives. Individuals whose intent is to use controlled substances for nonmedical purposes may also substitute unmonitored prescription drugs or street drugs for those that are monitored by the PDMP.
Like prescribers, patients may fear coming under scrutiny from law enforcement if they use
medications monitored by the PDMP, even if they have a legitimate medical need for the
medications. Patients may worry about changes in prescribing behavior, which may limit their access to needed medications. Patients may worry about the additional cost of more frequent office visits if prescribers become more cautious about writing prescriptions with refills. Patients may also have concerns about the privacy and security of their prescription information if it is submitted to a PDMP…
The Rise in Heroin Abuse
In March 2014, Attorney General Holder called the rise in heroin abuse “a sad but not unpredictable symptom of the significant increase in prescription drug abuse we’ve seen over the past decade.” While Attorney General Holder did not cite increased enforcement and monitoring as a reason for the rise in heroin abuse, others have stated that the crackdown on prescription drug abuse may have led users to turn to heroin, a cheaper alternative to prescription drugs that may be more easily accessible to some who are seeking an opiate high.
Policy makers may debate whether increased scrutiny and monitoring of prescription drug activity has unintentionally contributed to the increase in heroin abuse, and if this is the case, how should the government address this issue, if at all?
Prescription Drug Monitoring Programs (PDMPs) Interstate Data Sharing Status (current as of 1/21/2015)
Washington State’s Data Sharing Initiative with Medicaid and Workers’ Compensation
This project was supported by Grant No. 2011-PM-BX-K002 awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking…
Data from prescription drug monitoring programs (PDMPs) include virtually all prescriptions dispensed to a patient, including those paid for by cash, so use of PDMP data by third party payers allows more complete patient monitoring… Washington’s data sharing initiative shows promise as a model for providing PDMP data to third party payers, whether public or private, to help mitigate the prescription drug abuse epidemic…