Prescription Drug Monitoring Program Use by Opioid Prescribers: A Cross Sectional Study

Clinician use of Prescription Drug Monitoring Programs (PDMPs) has been linked to better patient outcomes, but state requirements to use PDMPs are unevenly enforced. We assessed PDMP use in Minnesota, which requires opioid prescribers to hold accounts and, in most cases, search the PDMP before prescribing, but where enforcement authority is limited. Using 2023 PDMP data, we find that four in ten opioid prescribers did not search and three in ten did not hold an account. PDMP use was strongly associated with prescribing volume, but even among the top decile of opioid prescribers, 8% never searched the PDMP. 32% of opioid fills came from clinicians who did not search. Failures to use the PDMP may be driven by a lack of information about state requirements, beliefs that these requirements are not enforced, and the costs of accessing the PDMP relative to the benefits. These results highlight the potential for policymakers to promote safer and better-informed prescribing of opioids and other drugs by addressing the forces that have limited PDMP use so far.