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Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse


  • Dhaval M. Dave
  • Anca M. Grecu
  • Henry Saffer


Despite the significant cost of prescription (Rx) drug abuse and calls from policy makers for effective interventions, there is limited research on the effects of policies intended to limit such abuse. This study estimates the effects of prescription drug monitoring (PDMP) programs which is a key policy targeting the non-medical use of Rx drugs. Based on objective indicators of abuse as measured by substance abuse treatment admissions related to Rx drugs, estimates do not suggest any substantial effects of instituting an operational PDMP. We find, however, that mandatory-access provisions, which raised PDMP utilization rates by actually requiring providers to query the PDMP prior to prescribing a controlled drug, are significantly associated with a reduction in Rx drug abuse. The effects are driven primarily by a reduction in opioid abuse, generally strongest among young adults (ages 18-24), and underscore important dynamics in the policy response. Robustness checks are consistent with a causal interpretation of these effects. We also assess potential spillovers of mandatory PDMPs on the use of other illicit drugs, and find a complementary reduction in admissions related to cocaine and marijuana abuse.

Suggested Citation

  • Dhaval M. Dave & Anca M. Grecu & Henry Saffer, 2017. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," NBER Working Papers 23537, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:23537
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    1. repec:aph:ajpbhl:10.2105/ajph.2016.303627_9 is not listed on IDEAS
    2. Jones, C.M. & Baldwin, G.T. & Compton, W.M., 2017. "Recent increases in cocaine-related overdose deaths and the role of opioids," American Journal of Public Health, American Public Health Association, vol. 107(3), pages 430-432.
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    Cited by:

    1. Bogdan Savych & David Neumark & Randall Lea, 2019. "Do Opioids Help Injured Workers Recover and Get Back to Work? The Impact of Opioid Prescriptions on Duration of Temporary Disability," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 58(4), pages 549-590, October.
    2. Itzik Fadlon & Torben Heien Nielsen, 2019. "Family Health Behaviors," American Economic Review, American Economic Association, vol. 109(9), pages 3162-3191, September.
    3. Gihleb, Rania & Giuntella, Osea & Zhang, Ning, 2020. "Prescription drug monitoring programs and neonatal outcomes," Regional Science and Urban Economics, Elsevier, vol. 81(C).
    4. Christopher J. Ruhm, 2018. "Deaths of Despair or Drug Problems?," NBER Working Papers 24188, National Bureau of Economic Research, Inc.
    5. Molly Schnell & Janet Currie, 2018. "Addressing the Opioid Epidemic: Is There a Role for Physician Education?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 383-410, Summer.
    6. Pohl, R. Vincent, 2018. "Time Trends Matter: The Case of Medical Cannabis Laws and Opioid Overdose Mortality," MPRA Paper 87237, University Library of Munich, Germany.
    7. Böckerman, Petri & Kortelainen, Mika & Laine, Liisa T. & Nurminen, Mikko & Saxell, Tanja, 2019. "Digital Waste? Unintended Consequences of Health Information Technology," Working Papers 117, VATT Institute for Economic Research.
    8. Gihleb, Rania & Giuntella, Osea & Zhang, Ning, 2018. "The Effects of Mandatory Prescription Drug Monitoring Programs on Foster Care Admissions," IZA Discussion Papers 11470, Institute of Labor Economics (IZA).
    9. Garin, Julio & Pohl, R. Vincent & Smith, Rhet A., 2018. "The Effect of Medical Cannabis Dispensaries on Opioid and Heroin Overdose Mortality," MPRA Paper 89613, University Library of Munich, Germany.
    10. Sumedha Gupta & Thuy D. Nguyen & Patricia R. Freeman & Kosali I. Simon, 2020. "Competitive Effects of Federal and State Opioid Restrictions: Evidence from the Controlled Substance Laws," NBER Working Papers 27520, National Bureau of Economic Research, Inc.
    11. Thomas C. Buchmueller & Colleen M. Carey & Giacomo Meille, 2020. "How well do doctors know their patients? Evidence from a mandatory access prescription drug monitoring program," Health Economics, John Wiley & Sons, Ltd., vol. 29(9), pages 957-974, September.
    12. Ahomäki, Iiro & Pitkänen, Visa & Soppi, Aarni & Saastamoinen, Leena, 2020. "Impact of a physician-targeted letter on opioid prescribing," Journal of Health Economics, Elsevier, vol. 72(C).
    13. Alexander Ahammer & Martin Halla, 2020. "The Intergenerational Transmission of Opioid Dependence: Evidence from Administrative Data," Economics working papers 2020-10, Department of Economics, Johannes Kepler University Linz, Austria.
    14. David Beheshti, 2019. "Adverse health effects of abuse‐deterrent opioids: Evidence from the reformulation of OxyContin," Health Economics, John Wiley & Sons, Ltd., vol. 28(12), pages 1449-1461, December.
    15. Robert Kaestner & Engy Ziedan, 2019. "Mortality and Socioeconomic Consequences of Prescription Opioids: Evidence from State Policies," NBER Working Papers 26135, National Bureau of Economic Research, Inc.
    16. Gihleb, Rania & Giuntella, Osea & Zhang, Ning, 2019. "Prescription Drug Monitoring Programs and Neonatal Outcomes," IZA Discussion Papers 12796, Institute of Labor Economics (IZA).
    17. Analisa Packham, 2019. "Are Syringe Exchange Programs Helpful or Harmful? New Evidence in the Wake of the Opioid Epidemic," NBER Working Papers 26111, National Bureau of Economic Research, Inc.
    18. Resul Cesur & Joseph J. Sabia & W. David Bradford, 2019. "Did the War on Terror Ignite an Opioid Epidemic?," NBER Working Papers 26264, National Bureau of Economic Research, Inc.
    19. Janet Currie & Hannes Schwandt, 2020. "The Opioid Epidemic Was Not Caused by Economic Distress But by Factors that Could be More Rapidly Addressed," NBER Working Papers 27544, National Bureau of Economic Research, Inc.
    20. Gal Wettstein, 2019. "Health insurance and opioid deaths: Evidence from the Affordable Care Act young adult provision," Health Economics, John Wiley & Sons, Ltd., vol. 28(5), pages 666-677, May.
    21. Ruhm, Christopher J., 2019. "Drivers of the fatal drug epidemic," Journal of Health Economics, Elsevier, vol. 64(C), pages 25-42.

    More about this item

    JEL classification:

    • H0 - Public Economics - - General
    • I1 - Health, Education, and Welfare - - Health
    • K0 - Law and Economics - - General

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