U.S. Opioid Epidemic: Impact on Public Health and Review of Prescription Drug Monitoring Programs (PDMPs)

Abstract

Objectives: In recent years, the devastating effects of U.S. opioid epidemic has been making news headlines.  This report explores background information and trends on opioid misuse, overdose fatalities and its impact on public health.  In addition, various efforts to improve surveillance, timeliness of data and Prescription Drug Monitoring Program (PDMP) integration and interoperability are reviewed.Method: PubMed and internet searches were performed to find information on the U.S. opioid epidemic.  In addition, searches were performed to retrieve information about PDMPs and state-specific mandates along with presentation slides and learnings from the 2018 National Rx Drug Abuse & Heroin Summit in Atlanta, GA.Results: It is clear that the U.S. opioid epidemic has a tremendous impact on public health including the next generation of children.  Various data, surveillance & technology-driven efforts including CDC-Funded Enhanced State Opioid Overdose Surveillance Program (ESOOS) and use of telemedicine for opioid use disorder treatment aim to improve prevention, treatment and targeted interventions.  In addition, PDMP integration and interoperability efforts are advancing to provide prescribers meaningful decision support tools.Discussion: The opioid epidemic has a complex impact on public health intertwined with variable factors such as mental health and social determinants of health.  Given the statistics and studies that suggest many of the illicit opioid users start with prescription opioids, continued advancement in the area of PDMP integration and interoperability is necessary.  The PDMP integrated clinical decision support systems need to supply to healthcare providers access to complete, timely and evidence-based information that can meaningfully inform prescribing decisions and communication with patients that affect measurable outcomes. Conclusion: While Prescription Drug Monitoring Programs (PDMPs) are valuable tools for providers in making informed prescribing decisions, the variable state mandates and varying degrees of integration and interoperability across states may limit their potential as meaningful decision support tools.  Sharing best practices, challenges and lessons learned among states and organizations may inform strategic and systematic use of PDMPs to improve public health outcomes.Key Words: opioid epidemic, prescription drug monitoring programs (PDMPs), prescription monitoring programs (PMPs)