Do Prescription Drug Monitoring Programs Increase Heroin Use?

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Do Prescription Drug Monitoring Programs Increase Heroin Use?

By Beth Leipholtz 05/11/18

A new study examined whether prescription opioid restrictions led to an increase in heroin use. 

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While the intention of prescription drug monitoring programs is to decrease deaths caused by overdose, the programs may actually be causing harm in another way: by steering some individuals to heroin. 

According to United Press International (UPI), a new study published in Annals of Internal Medicine has found that there may be a connection between such programs and an increase in heroin overdose deaths. 

David Fink, study author and doctoral candidate in epidemiology at Columbia, says the goal of the study was to determine how these programs affected overdoses, Science Daily states. 

"Our aim was to systematically search and review the literature to assess whether these programs are associated with changes in nonfatal or fatal overdoses," he said in the study. "The evaluations would also help us determine whether specific administrative features of PDMPs correlate with these outcomes and, if so, which elements are most influential."

Researchers examined 17 studies that looked at the impact of such programs. Of those 17, 10 were connected to a decrease in overdose deaths.

However, the remaining three studies determined that after the programs began, heroin-related overdose deaths increased. 

Dr. Silvia Martins, study co-author and associate professor of epidemiology at Columbia University's School of Public Health in New York City, said in a media release that the study’s findings implied some individuals may have substituted heroin for prescription medications. 

"This suggested to us that heroin substitution may have increased after ... restrictions on opioid prescribing," the media release read. "We therefore caution that programs aimed at reducing prescription opioids should also address the supply and demand of illicit opioids.”

UPI states that in the 16 years between 1999 and 2015, opioid prescriptions in the US increased by 350%. During that same timeframe, the overdose deaths from prescription opioids as well as heroin also increased. 

Authors of the study explained that the drug-monitoring programs use “centralized statewide data systems to track prescription data,” according to UPI. This can help identify both doctors who may be overprescribing as well as patients who may be abusing medications. 

As of now, all 50 US states and DC have such programs in place or have passed the necessary legislation to start such programs. 

Fink says more research is necessary before any conclusions can be drawn. 

"As such, it is crucial to determine if these programs are helping to reduce opioid overdose," he said. "So far, the definitive conclusion we can draw from our evaluation is that the evidence is insufficient and that much more research is needed to identify a set of 'best practices.’"

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