It is clear that the prescription opioid epidemic is a nationwide problem, but for now, one of the most important weapons against it is being wielded inconsistently from state to state. Prescription Drug Monitoring Programs (PDMPs) are state-run electronic databases of prescribing and dispensing information from healthcare providers and pharmacies. They can be accessed by providers and pharmacists, as well as law enforcement personnel and state health officials to identify patients at high risk for opioid abuse or drug diversion. However, who has to report, what they report, and when they report it varies widely by state.
According to information compiled by the PDMP Training and Technical Assistance Center, 21 states, including New York and Florida, have no mandatory reporting at all. Twenty-three states, including California, Ohio, and West Virginia, require both prescribers and dispensers to report, while five states require only prescribers, and three states require only dispensers.
Eleven states, including California, Florida, and Maine, collect information only on prescriptions for drugs classified as Schedule II through IV. Twenty-two states collect information on prescriptions for drugs in Schedules II-IV, plus “drugs of concern.” Thirteen states, including New York and Pennsylvania, collect information on Schedules II-V only, while five states collect information on these plus “drugs of concern.”
Drugs of concern are a group of drugs not currently controlled by federal statute, but which have the potential for harm or abuse. They include DXM, kratom, and salvia.
Timely reporting is critical to prevent misuse of prescription opioids. States vary widely in their reporting requirements. Only one state—Oklahoma—requires reporting at the point of sale. Reports are due within one day in 36 states, but not for 3 days or more in 13 other states. According to the Centers for Disease Control and Prevention, “If there is a long interval between dispensing and submission into the state PDMP, providers and other PDMP users will not have information on patients’ most recent prescriptions. Timely data, like in a ‘real-time’ PDMP, maximizes the utility of the prescription history data, with significant implications for patient safety and public health.”