When Are Prescribers Required to Use Prescription Drug Monitoring Programs?

Overview

Prescriber use mandates are state laws that require health care providers to check the prescription drug monitoring program (PDMP)—a state-based electronic database intended to help reduce misuse and diversion of controlled substances—under specific circumstances. Forty-one states have such a mandate, though requirements vary for when the PDMP must be checked.

States have set parameters for PDMP use, including which drugs prompt a check and how frequently such checks should be performed. Some states also allow exemptions from the mandate, such as prescriptions for terminally ill patients.

Comprehensive mandates apply to all prescribers and, at a minimum, to all initial opioid prescriptions. This type of mandate is associated with reductions in the number of opioid prescriptions and in multiple provider episodes—when patients visit numerous prescribers or pharmacies to obtain the same or similar drugs in a short time span.

Using data from the National Alliance for Model State Drug Laws and the PDMP Training and Technical Assistance Center at Brandeis University, Pew analyzed how states structure the laws and regulations that define when and under what circumstances prescribers are required to check the PDMP. After that assessment, Pew reviewed state laws and regulations to verify these circumstances.

This text was updated Jan. 30, 2018, to clarify that data were used from the PDMP Training and Technical Assistance Center; data are current as of May 2018.

Please contact [email protected] with additions or updates.

Select a system

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State selection 1

State 1

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State selection 2

State 2

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{{ state.state === 'Select a state' ? 'Clear' : state.stateAbbrev }}{{ state.universalPDMPUse ? '*' : '' }} {{ state.state === 'Select a state' ? 'Clear selection' : state.state }}{{ state.universalPDMPUse ? '*' : '' }}

State selection 3

State 3

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{{ state.state === 'Select a state' ? 'Clear' : state.stateAbbrev }}{{ state.universalPDMPUse ? '*' : '' }} {{ state.state === 'Select a state' ? 'Clear selection' : state.state }}{{ state.universalPDMPUse ? '*' : '' }}

Type of mandate

Does the mandate apply to all prescribers and at least all initial opioid prescriptions?

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Drugs included^†

What drugs are included in the mandate?

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States may define controlled substance schedules to be more inclusive than DEA-defined schedules. Schedules are also fluid over time and can be changed at the federal or state level to include or exclude certain drugs. Therefore, in developing this table, Pew followed the language in state law, which applies to state-defined schedules unless otherwise indicated.

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Timing triggers

Is the prescriber required to review the PDMP for the initial prescription for drugs that are subject to the mandate?

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Is the prescriber required to review the PDMP at regular intervals after the initial prescription?

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Are there other timing triggers?

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Exceptions to PDMP review

Are short duration prescriptions exempt from the mandate?

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Are prescriptions for terminally ill patients exempt from PDMP review?

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Are prescriptions issued or administered at hospitals and long-term care facilities exempt from the mandate?

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Is there an exception to the mandate if the PDMP is inaccessible?

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Are there other exceptions?

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When Are Prescribers Required to Use Prescription Drug Monitoring Programs?

Data show mandates vary across states

Overview

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Comparative chart of systems

Type of mandate

Drugs included^†

Timing triggers

Exceptions to PDMP review

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