Prescription Monitoring Programs: Striking the Balance Between Medical Use and Diversion

Over the past decade, the medical use, abuse, and diversion of controlled prescription medications has markedly risen, resulting in increased overdose, death, and need for treatment. In 2006, in response to this growing public health problem, the Office of National Drug Control Policy called for a 15%% reduction in prescription drug abuse and diversion. Addressing the fine balance between reductions in prescription abuse without attendant reductions in legitimate medical access remains a primary challenge. In its mandate, the ONDCP called for expansion of the Prescription Monitoring Programs (PMPs), state-level initiatives intended to monitor the prescribing, dispensing, and consumption of targeted pharmaceutical products. To date, 38 states have adopted a PMP. Rigorous empirical evaluation of these programs is scant, with findings suggesting that paper-based programs markedly reduce use of controlled prescription medications; however, it is not clear whether these reductions are due to decreases in abuse and diversion and/or decreases in medical use. Despite Federal expenditures exceeding $$100 million, and considerably more by State governments, the effectiveness of PMPs in reducing prescription drug abuse and diversion remains unclear.</.