Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse
Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse
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DOI：
10.1002/pam.22098
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发表时间：
2019-01-01
影响因子：
3.8
通讯作者：
Saffer, Henry
中科院分区：
文献类型：
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作者：
Grecu, Anca M.;Dave, Dhaval M.;Saffer, Henry
尽管处方药滥用成本高昂，决策者也呼吁采取有效干预措施，但对旨在限制这种滥用的政策的影响的研究有限。本研究估计处方药监测（PSTs）计划的影响，这是一个关键的政策，目标是获得非医疗使用的Rx药物。根据药物滥用治疗入院率和与Rx药物相关的死亡率衡量的客观滥用指标，估计并不表明建立可操作的PDMP有任何实质性影响。然而，我们发现，强制访问规定，实际上要求供应商查询处方前的受管制药物，与减少Rx药物滥用，提高了PADER的使用率。这些影响主要是由于类阿片滥用减少，在年轻人（18至24岁）中一般最为明显，并强调了政策应对措施的重要动态。稳健性检查与这些效应的因果解释一致。我们还评估了强制性PDMP对使用其他非法药物的潜在溢出效应，并发现与可卡因和大麻滥用有关的入院率有所下降。
Despite the significant cost of prescription (Rx) drug abuse and calls from policymakers 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 constitute a key policy targeting access to non-medical use of Rx drugs. Based on objective indicators of abuse as measured by substance abuse treatment admissions and mortality 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 to 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.