Utilizing PDMP Databases to Improve Patient Care in Opioid Treatment Programs

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.

  • About NDRI
          Since 1967, National Development and Research Institutes, Inc. (NDRI), a private, not-for-profit 501(c)(3) organization, has conducted substance use and other bio-behavioral research nationwide and throughout the world.

          Drawing on the expertise of our interdisciplinary professional staff and our partners such as medical centers, treatment and prevention programs, universities, CBOs, industry and government NDRI has advanced public health across diverse populations including high-risk and underserved persons, uniformed services, youth and veterans.

          In addition to its focus on addiction, NDRI, organized under specialized institutes, has generated scientific discoveries associated with infectious diseases (particularly HIV and Hepatitis C), overdose, chronic pain, prevention of cardiovascular disease and cancer, tobacco control and criminal justice.

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