Monitoring programs can help address opioid epidemic, UK research shows

New research from the UK College of Public Health suggests state drug-monitoring programs are effective in reducing the number of opioids prescribed to Medicaid recipients.

Led by researcher Hefei Wen, the study shows that state requirements for healthcare providers to participate in prescription-drug monitoring programs, or PDMPs, have influenced safer prescribing practices for Medicaid patients. Published in the April edition of Health Affairs, the research suggests state PDMP mandates are linked with reduced opioid prescriptions received by Medicaid patients as well as Medicaid spending on opioid prescriptions by as much as 10 percent.

The analysis done by Wen and her team showed state mandatory registration or use of a PDMP reduced Schedule II opioid prescriptions and spending by 9 to 10 percent between 2011 and 2014. The results suggest programs like these are effective in promoting safer and more contained prescribing of opioids with high potential for abuse and dependence. These implications support PDMP mandates as effective in addressing the opioid epidemic.

Forty-nine states and the District of Columbia have PDMPs in place to help providers identify patients at high risk of misusing or abusing controlled substances. However, the average registration rate across the states is low, and most registered prescribers do not use PDMPs on a consistent basis.

An increasing number of states that have implemented mandates that require providers to register with the monitoring programs and to use program data when prescribing opioids and other controlled substances. For instance, in 2012, legislators in Kentucky passed one of the most comprehensive mandates.

The Kentucky mandate requires prescribers to register with the Kentucky All Schedule Prescription Electronic Reporting System (KASPER). Then, they must query the KASPER system for all first-time prescriptions and a minimum of every 12 months after the first prescription. Similarly strong mandates can help improve participation in PDMPs and fulfill their potential in addressing the opioid epidemic.

Wen is an assistant professor in health management and policy in the UK College of Public Health. Her research leverages economic thinking to inform health care and public safety, with a concentration on behavioral health and drug control policy.

Next steps:

• Learn more about the UK College of Public Health, which looks for solutions to public health challenges through teaching, research and service.
• Read about a promising clinical trial at UK related to opioid-use disorders.