Must-Access Prescription Drug Monitoring Programs and the Opioid Overdose Epidemic: The Unintended Consequences
43 Pages Posted: 21 Jan 2020 Last revised: 9 Dec 2020
Date Written: January 2020
Although supply-side drug policies that limit access to legal opioids have reduced prescription opioid abuse, growing evidence shows that these policies have had the unintended consequence of increasing use of illegal opioids, including heroin. I add to this literature by studying the consequences of must-access prescription drug monitoring programs (PDMPs), which legally require providers to access a state-level database with a patient's prescription history before prescribing controlled substances under certain circumstances. Using a difference-in-differences specification, I find strong evidence that must-access PDMPs have increased heroin death rates. My estimates indicate that two years after implementation, must-access PDMPs were associated with 1.12 more heroin deaths per 100,000 in a half-year period, relative to control states. Moreover, I find that prescription opioid death rates declined following implementation. My results suggest that even if must-access PDMPs reduce prescription opioid deaths, the decrease is offset by a large increase in illegal opioid deaths.
Keywords: Prescription Drug Monitoring Program, PDMP, Must-Access PDMP, Opioid, Heroin, Opioid Overdose, Opioid Epidemic
JEL Classification: H75, I12, I18, K42
Suggested Citation: Suggested Citation