Principal Investigator: Harlan Matusow
Data from prescription drug monitoring programs (PDMPs) are increasingly used by opioid treatment programs and office-based opioid treatment providers (OTPs) to ensure that if patients are being prescribed controlled substances, they are medically warranted and taken as directed. In the absence of this information, treatment providers do not have the resources to effectively manage care, and their patients are at increased risk of continued addiction, overdose, and death. Others may be diverting prescription drugs. Accessing the data from PDMP databases can guide therapeutic decision making and assist in better understanding how patients continue to use or abuse prescription opioids as they remain in treatment. This will also assist OTPs in better differentiating what medications to offer the patients during the course of treatment.
Under a subcontract from the American Association for the Treatment of Opioid Dependence, we undertook to survey 13 OTPs to assess their PDMP practices. We compared baseline usage (12/31/14) with quarterly rates of usage over calendar year 2015. Overall, rates of unreported prescriptions among OTP enrollees were not significantly different from those already in treatment when the study commenced. On a quarterly basis, unreported prescriptions were relatively stable, and the composite numbers at the end of the year were not significantly different from those at baseline,
Two questions deserve further scrutiny: 1) Why do some programs consistently fail to check the PDMP, even when 10-15% of those persons checked are found to have unreported prescriptions? 2) What factors lead to discharge of the 20-25% of those patients with unreported prescriptions?
Once these questions are answered, we need to identify ways in which the PDMPs can be used in the service of keeping people in treatment, rather than in discharging 1 in 5.