The Effect of Mandatory Access Prescription Drug Monitoring Programs on Foster Care Admissions

The opioid epidemic is a national public health emergency. As the number of fatal overdoses and drug abuse skyrocket, children of opioid-dependent parents are at increased risk of being neglected, abused or orphaned. While a few studies have examined the effects of policies restricting prescription drug supply on drug abuse, we know less about the effects these policies may have on children of opioid-dependent parents. This paper estimates the effect of mandatory prescription drug monitoring programs (PDMPs) on child removals. To identify the effects of the programs on foster care admissions, we exploit the variation across states in the timing of adoption of mandatory PDMPs, using an event-study approach as well as standard difference-in-difference models. Consistent with previous evidence examining the effects of PDMPs on drug abuse, we find that operational PDMP did not have any significant effects on foster care admissions. However, the introduction of mandatory provisions reduced child removals by 10\%. Exploring the reasons of removals, we show that these effects are driven by the reductions in first removals and cases of child neglect. There is also evidence of significant reductions in removal cases associated with child physical abuse. Effects are strongest among children of young caregivers.