The Impact of Prescription Drug Monitoring Programs on U.S. Opioid Prescriptions

24 Pages Posted: 19 Apr 2018

See all articles by Ian Ayres

Ian Ayres

Yale University - Yale Law School; Yale University - Yale School of Management

Amen Jalal

Yale University

Date Written: January 10, 2018


This paper seeks to understand the treatment effect of Prescription Drug Monitoring Programs (PDMPs) on opioid prescription rates. Using county-level panel data on all opioid prescriptions in the U.S. between 2006 and 2015, we investigate whether state interventions like PDMPs have heterogeneous treatment effects at the sub-state level, based on regional and temporal variations in policy design, extent of urbanization, race, and income. Our models comprehensively control for a set of county and time fixed effects, county-specific and time-varying demographic controls, potentially endogenous time-series trends in prescription rates, and other state-level opioid interventions such as Naloxone Access and Good Samaritan laws, Medicaid expansion, and the provision of Methadone Assistance Treatment. We find that PDMPs are only effective in reducing prescription rates if they obligate doctors to check for patients’ history prior to filling out a prescription, but the frequency at which a state requires its PDMP to be updated is irrelevant to its effectiveness. Moreover, the significant treatment effects of PDMPs are almost exclusively driven by urban and predominantly white counties, with the relatively more affluent regions showing greater responsiveness than their less affluent counterparts.

Keywords: Opioids, Prescription Drug Monitoring Programs (PDMPs), Naloxone Access Laws, Good Samaritan Laws, Medicaid Expansion, Methadone Assistance Treatment (MAT), Health Policy, Public Health, County-Level Panel Data

JEL Classification: I1, K32, R00

Suggested Citation

Ayres, Ian and Jalal, Amen, The Impact of Prescription Drug Monitoring Programs on U.S. Opioid Prescriptions (January 10, 2018). Available at SSRN: or

Ian Ayres (Contact Author)

Yale University - Yale Law School ( email )

P.O. Box 208215
New Haven, CT 06520-8215
United States
203-432-7101 (Phone)
203-432-2592 (Fax)

Yale University - Yale School of Management

135 Prospect Street
P.O. Box 208200
New Haven, CT 06520-8200
United States

Amen Jalal

Yale University ( email )

New Haven, CT 06520
United States

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