Evolution of PDMPs: Public Health Surveillance in North Carolina and Patient Safety in Ohio

Prescription Drug Monitoring Programs (PDMPs) were primarily designed for use by clinical practitioners and law enforcement to improve clinical practice and prevent diversion. This session will present two examples of states expanding their utility.

The first presentation will demonstrate how Ohio added external data related to drug use into the PDMP, creating a pathway towards safer prescribing and better patient outcomes. Ohio was the first state to integrate data from drug courts and opioid treatment programs (OTPs) into a PDMP. The drug court indicator flag was added in February of 2021 and in the first year of the program, almost 10,000 patient reports were returned with that flag enabled. Thanks to data collected after a patient consent program was created with the Ohio Mental Health and Addition Services agency, an indicator is displayed on patients’ PDMP reports if they are currently in an OTP. By informing select PDMP users of a patient’s drug history beyond prescription data, prescribers are better informed, so as to reduce the chance of relapse or overdose for impacted patients. In addition to the health outcomes, this information can also help patients to stay compliant with external treatment agreements.

In North Carolina, the PDMP ― the Controlled Substance Reporting System (CSRS) ― is well established as a clinical practice and diversion prevention resource and is now being systematically developed to increase its public health utility. Public health epidemiologists and CSRS program staff collaborate to identify and implement public health utility in the dataset. The Centers for Disease Control and Prevention’s Overdose Data to Action (OD2A) funding supports a structured approach to improving CSRS functionality and usability to conduct surveillance of North Carolina’s overdose crisis. Through this effort, several surveillance projects have been developed. The team started by including simple descriptive statistics around opioid dispensing in the state’s overdose data dashboard. Building upon that monthly update, the dashboard now includes buprenorphine dispensed. Additional projects in the works include an analysis linking overdose deaths to controlled substance dispensing histories.