Prescription Drug Monitoring: Doesn't Save Lives, Causes Unnecessary Pain, but at Least It's Monitoring


Followup to what Jacob Sullum wrote earlier today about the idiotic cruelty of Miami Herald columnist Carl Hiaasen getting on Florida Gov. Rick Scott's case for not being for prescription drug monitoring databases, allegedly important for the completely unimportant public policy concern of stopping people from "abusing" painkillers.

The latest research on Prescription Drug Monitoring Programs (PDMPs) shows, unsurprisingly (not that their proponents care at all, at all) that they do nothing to prevent overdoses. From Pain Treatment Topics:

Beginning in 2003, development of PDMPs have been supported in part by federal funding from the U.S. Department of Justice and the Department of Health and Human Services, and with passage in 2005 of the National All Schedules Prescription Electronic Reporting Act, or NASPER, state PDMPs have proliferated. As of spring 2010 a total of 35 states had operational programs and 6 states had enacted legislation authorizing such programs [data can be accessed here].

….Writing in the February 2011 online edition of the journal Pain Medicine, a team from the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, led by Leonard Paulozzi, MD, MPH — a widely-respected medical epidemiologist in the Division of Unintentional Injury Prevention — quantify the impact of PDMPs on mortality rates from drug overdose and how these rates compare with quantities of opioid drugs distributed at the state level [Paulozzi et al. 2011].

For their retrospective observational study the investigators accessed U.S. mortality data by state and by year for 1999 through 2005. Overdose deaths, excluding suicides, involving opioid analgesic poisoning were identified, and other data were gathered covering the time period of interest, including U.S. demographic data and distribution data for the 7 most commonly prescribed opioids: the Schedule III drug hydrocodone, and the Schedule II drugs fentanyl, hydromorphone, meperidine, methadone, morphine, and oxycodone. During at least some portion of the 6-year observational period, 19 states had operational PDMPs.

The investigators found that during the study period the nationwide rates for drug overdose mortality approximately doubled overall and rates specifically for opioid-related overdose mortality tripled. At the same time, average per-person opioid analgesic consumption throughout the U.S. roughly tripled. Surprisingly, the operation of PDMPs were NOT significantly associated with any lower rates of drug overdose or opioid overdose mortality, or with declining rates of opioid drug consumption…..

Paulozzi and coauthors conclude that, "…it can be said unequivocally that PDMP states did not do any better than non-PDMP states in controlling the rise in drug overdose mortality from 1999 to 2005." Not only were PDMPs a failure in stemming drug overdose mortality but their expected effect on overall consumption of opioids appeared to be minimal.

Radley Balko wrote for us back in February 2008 on drug warrior opposition to the drug naloxone, which can save the lives of people overdosing on opiates.

[Hat tip: the Drug Policy Alliance's Meghan Ralston]