The Effect of Prescription Drug Monitoring Programs on Opioid Prescriptions and Heroin Crime Rates

In response to growing abuse of prescription opioid painkillers, 50 U.S. states have implemented electronic prescription drug monitoring programs (PDMPs) that record patients into a state-wide registry when a prescription opioid is received. This paper uses a difference-in-differences regression framework and interactive fixed effects factor models to identify the effect of PDMPs and two related programs on the types and strengths of opioid painkiller prescriptions filled and on rates of heroin crimes. The implementation of PDMP databases caused an 8% decrease in the amount of oxycodone shipments, with results from Medicaid prescription data pointing to larger decreases within high dosage pills. PDMPs have heterogeneous effects on heroin crime incidents across counties depending on the county’s pre-policy level of prescription opioid milligrams per capita, with an 87% increase in heroin crime within the most opioid-dense counties.