摘要：Prescription monitoring programs (PMPs), state-level databases that collect patient-specific prescription information at the time medications are dispensed, have been suggested as tools to address the overdose epidemic. We reviewed all laws in the United States (n = 25) that articulated the purposes PMPs are intended to serve. Attributes related to reducing abuse, misuse, and diversion of prescription medications appeared most commonly. Only 5 purpose statements mentioned the promotion of public health as goals of the PMP, and only 3 listed improving health care. None listed overdose prevention as a goal of the PMP. Fatal poisonings, most of which are caused by drug overdose, have increased by nearly 600% over the past 3 decades and are now the leading cause of injury death in the United States. 1 The age-adjusted rate of prescription opioid-involved deaths nearly quadrupled between 1999 and 2011, closely mirroring increases in opioid medication prescriptions. 2,3 Heroin-related deaths have likewise increased dramatically, a rise at least partly attributable to prescription opioid users transitioning to heroin, which is less expensive and increasingly more accessible than prescription opioids. 4,5 Prescription monitoring programs (PMPs) are state-level databases that collect patient-specific prescription information at the time medications are dispensed. 6 Numerous federal agencies and nongovernmental organizations have suggested them as key components in the effort to stem the tide of preventable overdose deaths. The past decade has seen a rapid increase in both the number of states mandating the programs and the amount and timeliness of the data collected. 6 However, evidence of the effectiveness of the programs in reducing overdose deaths is mixed, and a recent survey of state PMP program Web sites found that although nearly all emphasize the potential role of PMPs in reducing the supply of prescription opioids, only 38% noted their potential role in reducing overdose and only 17% contained overdose prevention information. 7,8 In this public health policy brief, we report that the legislation establishing PMPs and guiding their operation most often cites the prevention of diversion, abuse, and misuse of prescription medications as the programs’ goals, followed by benefits to practitioners. The goals of public health promotion and patient protection appear less often, and no states list a reduction in overdose or overdose deaths as goals of the programs. We suggest that modifying state law to explicitly specify that the PMPs’ goals include reducing overdose and other drug-related harms may improve the effectiveness of the programs as health promotion and overdose reduction tools.
