Usefulness of Prescription Monitoring Programs for Surveillance—Analysis of Schedule II Opioid Prescription Data in Massachusetts, 1996–2006

Nathaniel Katz, MD, MS

Tufts University School of Medicine
Boston, MA

Clinicians who treat pain must balance the powerful analgesic profile of opioids with the growing problems of nonmedical use and diversion. Several tools have been developed to promote safe opioid prescribing. For example, most US states have implemented or are in the process of implementing prescription monitoring programs (PMPs). The Massachusetts PMP tracks prescriptions of all Schedule II drugs, which includes most opioids. Dr Katz and colleagues analyzed 11 years (1996-2006) of Massachusetts PMP data to identify trends in opioid prescribing, dispensing, and usage. A general increase in opioid prescribing was noted over the analyzed period. The authors also examined questionable activity, which was defined as the use of >4 prescribers and >4 pharmacies, suggesting that the patient was ‘doctor shopping.’ Among all opioid prescriptions in the dataset, questionable activity was observed for 0.5% of individuals, 3.1% of prescriptions, and 3.1% of dosage units. Among the various opioids, short-acting oxycodone was most strongly associated with questionable activity. This data highlights the utility of PMPs for monitoring medical and nonmedical use of prescription opioids.

References

Katz N, Panas L, Kim M, et al. Usefulness of prescription monitoring programs for surveillance—analysis of Schedule II opioid prescription data in Massachusetts, 1996-2006. Pharmacoepidemiol Drug Saf. 2010;19(2):115-123.
Miller MM, Brown RT. Prescription drug monitoring programs. Am Fam Physician. 2007;75:810-811.
Brushwood DB. Maximizing the value of electronic prescription monitoring programs. J Law Med Ethics. 2003;31:41-54.
Fishman SM, Papazian JS, Gonzalez S, et al. Regulating opioid prescribing through prescription monitoring programs: balancing drug diversion and treatment of pain. Pain Med. 2004;5:309-324.

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