Statewide prescription drug monitoring programs were introduced to reduce the supply of opioids and protect patients. Due to the opioid epidemic and the rocketing number of overdoses and fatalities, in the last few years there’s been an increase in their use across the US. There’s been limited research into their effectiveness, however, the aim is to provide physicians with access to databases, including information from other physicians and hospitals, which enables them to flag patients who are at a higher risk of abusing their medication.
However, a new study has shown that, despite some of their features being useful to physicians, they aren’t as effective and previously hoped. The study took into account data from fifty states across the US between 1999 and 2016, which included information about prescription drug abuse, overdoses and fatalities. The results seen were inconsistent; some of the data showed increases; some showed decreases; some showed no change in overdoses.
David Fink, a social epidemiologist at Columbia University’s Mailman School of Public Health and a leading author of the study said: “Studies have come out in the past looking at reduced prescribing behavior, but we’re taking it to the next level — looking at fatal or nonfatal overdoses. And what we’re seeing is that when you actually look at the literature, it isn’t that strong to support.”
As well as there being a lack of evidence to support the effectiveness of the programs. the researchers also found there were other unintended consequences. For example, some of the data indicated that in areas where prescription drug monitoring programs were introduced, there was an increase in the number of heroin deaths. “This result highlights what many would call the substitution effect: when people substitute one drug for another,” said Sheila Vakharia, policy manager for the Drug Policy Alliance, who was not involved in the study.
She added: “According to the substitution effect, people who have become dependent on prescribed opioids and lose convenient access to them may substitute with heroin. However, illicit heroin is often of unknown quality and purity … so it can increase risk of accidental overdose and poisoning. Restricting supply generally has little impact on demand and can be a costly waste of resources when demand-side interventions deliver more meaningful results and changes”
She also noted that using interventions as an alternative “increases in access to mental health treatment, increases in access to evidence-based substance use treatment like medication-assisted treatments (methadone and buprenorphine) … and increased investments in other community level supports and social services which can help improve quality of life.”