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Member Research & Reports

Member Research & Reports

Columbia: State Prescription Drug Monitoring Programs – The Rise and Fall in Heroin Fatalities

A study at Columbia University Mailman School of Public Health found a consistent association between the adoption of state Prescription Drug Monitoring programs (PDMP) and death rates from heroin poisoning. although rates vary by program type. States with Proactive Prescription Drug Monitoring programs, which are more likely to report outlying prescribing and dispensing and provide broader access to law enforcement, reported a 6 percent reduction in heroin poisoning mortality by the program’s third year.

PDMPs are state-level databases of information collected on controlled prescription medications dispensed in a particular state. As of 2017, all U.S. states except Missouri had an operational monitoring program. Heroin poisonings in the U.S. have increased nearly 5-fold from 2010 to 2017.

Researchers studied programs for 2002 to 2016 and classified them as Cooperative, Proactive, and Weak for each state and year, across three intervals: 1999–2004, 2005–2009, 2010–2016.

States with Cooperative prescription drug monitoring reported 19 percent higher heroin poisoning rates compared to states with Weak PDMPs. Cooperative PDMPs share data with other states, include more drug schedules and require more frequent reporting.

“Our findings raise questions about the potential for certain types of drug monitoring programs to support efforts to decrease heroin overdose risk, but on the other hand, there are types of PDMPs associated with a decrease in heroin poisoning mortality,” said Dr. Silvia Martins, associate professor of epidemiology, and lead author.

Another finding showed there is a consistent, positive association between state electronic PDMP adoption and heroin poisoning mortality. By the 3rd year there was a 22 percent increase in heroin poisoning rates.

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