The Role of Information in the Market for Opioid Pain Relievers: An Analysis of Prescription Monitoring Programs

Drug overdose rates in the US have increased 150% since 1999, with prescription opioid pain relievers accounting for much of that increase. In response, many states have implemented prescription drug monitoring programs (PDMPs), which are electronic databases that track the prescribing and dispensing of controlled substances. They are intended to inform treatment decisions and identify and prevent “doctor shopping” and illicit prescribing or dispensing. This paper investigates the impact of state prescription drug monitoring programs on the abuse of opioid pain relievers. The outcomes analyzed here include non-medical use of pain relievers, substance abuse treatment admissions for opioid abuse and accidental opioid overdose deaths. I estimate difference-in-differences models in which I use variation in the timing of PDMP implementation across states as a source of exogenous variation in exposure to the program to identify impacts of PDMPs. I address possible policy endogeneity by controlling for pre-implementation trends as well as seven other types of state laws that are likely to affect prescription drug abuse and diversion. Results suggest that PDMPs reduced opioid abuse treatment admissions by 13.1%. I find suggestive evidence that PDMPs may have reduced non-medical use of Oxycontin and accidental opioid overdose deaths as well.