The Effects of Prescription Drug Monitoring Programs on the Opioid Abuse Epidemic

Abstract

Opioid abuse is currently the most significant public health problem in the US. Many US states have implemented prescription drug monitoring programs (PDMPs) in response. In this paper, I use a new micro-level medical claims database to exploit state-level and time-series variations in PDMP implementation and shed light on the impacts of these programs. My results show that PDMPs have led to an overall 14% percent reduction in the odds ratio of abuse/addiction. Also, there is evidence of substantial heterogeneity in impacts, with larger impacts for females and minorities. Another finding is that at least 23% of opioid abuse is a result of drug diversion to nonmedical opioid users. PDMPs were not successful in decreasing the rate of abuse for this group and, in fact, there is some evidence that they increased the diversion to heroin. Finally, I show that PDMPs' effectiveness varies by type of insurance and that they are more effective in reducing abuse rates in the general population as compared with Medicare Part D recipients. I use my estimates to analyze the potential effects of modifying PDMPs to include giving insurance providers to electronic databases, providing educational programs for less-educated people, and expanding their must access requirement.