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	Photo: Pills on a prescription pad.Impact of prescription drug monitoring programs and pill mill laws on high-volume opioid prescribers: A comparative interrupted time series analysis

Prescription drug monitoring programs (PDMPs) and “pill mill” laws have been used to target risky opioid prescribing practices. A new CDC Injury Center  study published in Drug and Alcohol Dependence evaluates the effect of these policy changes on high-volume prescribing behaviors among providers in Florida.

In the year following PDMP and policy implementation, decreases were seen among high-volume prescribers in the number of patients with an opioid prescription, monthly total opioid volume, average morphine equivalent dosage dispensed, and number of opioid prescriptions. Despite these decreases, opioid prescribing remained concentrated among high-volume prescribers, suggesting that payer/insurer initiatives and other policy changes that address risky prescribing practices are also needed to reduce opioid use, abuse and overdose.

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An analysis of Washington prescription drug monitoring program (PDMP) data revealed that multiple provider episodes (MPEs) vary by age group and class of prescription drug. Opioids and opioid combinations had the highest number of days of overlapping prescriptions, and eight opioids had a mean daily dosage greater than 120 morphine milligram equivalents (MME). Findings indicate that MPEs, overlapping prescription, and mean daily dosages over 100 MMEs are patient risk factors to look for in PDMP data.

Maine’s PDMP data was analyzed to examine several patient risk measures for prescription drug misuse, abuse and overdose. Patients aged 35-54 had the highest rate of MPEs, and opioids were the drug class most frequently involved with MPEs. However, the rate of MPEs declined from 2010 to 2014, and this coincided with an increase in prescribing of buprenorphine, widely used in treating opioid dependence.