Prescription Monitoring Programs Detect Abuse, Misuse of Controlled Substances

States can use their prescription drug monitoring programs (PDMPs) to detect abuse and misuse of controlled substances, according to a report in the CDC’s Morbidity and Mortality Weekly Report Surveillance Summary.

Researchers analyzed data from PDMPs in California, Delaware, Florida, Idaho, Louisiana, Maine, Ohio, and West Virginia. They found that prescribing practices varied widely among the states despite the fact that they are similar in the prevalence of the conditions controlled substances are used to treat.

According to the researchers, the findings show a need for improved prescribing practices, particularly for opioids, which were prescribed twice as often as stimulants or benzodiazepines in all 8 states.

“Every day, 44 people die in American communities from an overdose of prescription opioids and many more become addicted,” CDC Director Tom Frieden, MD, MPH, said in a statement. “States are on the frontline of witnessing these overdose deaths. This research can help inform their prescription overdose prevention efforts and save lives.”

The researchers found that a small minority of prescribers was responsible for most opioid prescriptions. In Delaware, the top 1% of prescribed in terms of their prescriptions wrote 1 in 4 opioid prescriptions compared with 1 in 8 in Maine. In Delaware this represents approximately 19 opioid prescriptions per day. In all states, the top 10% of prescribers wrote half or more of the opioid prescriptions.

According to the data, multiple-provider episode rates were highest in Ohio and lowest in Louisiana. Only 5 of the 8 states collected method of payment information, and the data showed the percentage paid for by cash for controlled substances varied 3-fold while the percentage paid for by Medicaid varied 6-fold.

“A more comprehensive approach is needed to address the prescription opioid overdose epidemic, including guidance to providers on the risks and benefits of these medications,” said Debra Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control.