Combatting the Prescription Painkiller Epidemic: A National Prescription Drug Reporting Program

36 Pages Posted: 27 May 2013 Last revised: 3 Jul 2013

Date Written: June 1, 2013


Prescription painkiller abuse is the fastest growing drug problem in the United States. Approximately, 1 out of every 20 twenty Americans reported misuse or abuse of prescription painkillers in the past year. Several factors contribute to the prescription painkiller epidemic. Drug abusers use various methods — such as doctor shopping, paying with cash, and filling prescriptions in different states — to avoid detection and obtain prescription painkillers for illegitimate uses. A few rogue physicians and pharmacists, lured by substantial profits, enable drug abusers by illegally prescribing or supplying controlled substances. Even ethical physicians rarely have adequate training to recognize and address prescription drug abuse, and as a result, prescribe painkillers to patients that are not using them for legitimate medical purposes. Similarly, although the majority of pharmacies have taken steps to combat drug abuse and reduce prescription painkiller dispensing, under current reporting systems, pharmacists lack visibility into several important indicators of drug abuse. As a result, vigilant pharmacists find it extremely difficult to identify and detect drug abuse with certainty.

While state governments have established prescription drug monitoring programs (PDMPs) to crack down on prescription drug abuse, these programs have proven to be inadequate. The programs currently suffer from inadequate data collection, ineffective utilization of data, insufficient inter-state data sharing, and constraints on sharing data with law enforcement and state agencies. By contrast, third-party prescription payment systems run by pharmacy benefit managers (PBMs) or health insurers have been effective in detecting prescription drug abuse. This paper suggests that a national prescription drug reporting program building on existing PBM networks could be significantly more effective than existing state PDMPs in detecting prescription drug abuse.

Keywords: drug abuse, prescription drug monitoring program, pharmacy benefit manager

JEL Classification: K

Suggested Citation

Shepherd, Joanna, Combatting the Prescription Painkiller Epidemic: A National Prescription Drug Reporting Program (June 1, 2013). American Journal of Law and Medicine, Vol. 40, No. 1, Forthcoming; Emory Legal Studies Research Paper No. 13-246. Available at SSRN: or

Joanna Shepherd (Contact Author)

Emory University School of Law ( email )

1301 Clifton Road
Atlanta, GA 30322
United States
404-727-8957 (Phone)

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