A Sunshine State News article, now posted on the website of the Florida House of Representatives, argues that a pair of studies “throws cold water” on the Prescription Drug Monitoring Program (aka PDMP) supported by the likes of Senate President Mike Haridpolos, Sen. Mike Fasano and Attorney General Pam Bondi, but opposed by Gov. Rick Scott and the leadership of the House of Representatives, which recently passed a bill to kill the program. #
The Sunshine story doesn’t link to any of the studies, and it appears to quote them rather selectively, to put it charitably. Its first quote comes straight out of the abstract of one of the studies, which is available in full here (.pdf): #
Researchers Ronald Simeone and Lynn Holland found that “the probability of pain-reliever abuse is actually higher in states that have PDMPs than in states that do not.” #
Here’s the full quote, emphasis added: #
It is important to note that the probability of pain reliever abuse is actually higher in states that have PDMPs than in states that do not. But our analysis demonstrates that in the absence of such programs the probability of abuse would be higher still. #
The article goes on to further mischaracterize the study, as well as the Senate’s plan for cracking down on pill mills: #
“The evidence suggests that states which are proactive in their approach to regulation are more effective in reducing the per-capita supply of prescription pain relievers and stimulants,” declared the 2006 study, titled “An Evaluation of Prescription Drug Monitoring Programs.” #
By contrast, the Simeone-Holland study found that states which are “reactive” tend to be less effective in controlling prescription-drug abuse. #
The Florida Senate’s proposed prescription-drug database falls into the “reactive” category, since it simply monitors drug transactions, without proactively enforcing laws that would block certain sales. #
The study actually finds that “the presence of a PDMP reduces per capita supply of prescription pain relievers and stimulants, and that this in turn reduces the probability of abuse for such drugs.” See for yourself on page 39. #
The study doesn’t say that a PDMP like the one supported by the Senate “simply monitors” drugs, or that such an approach is “reactive.” The terms “reactive” and “proactive” describe different types of monitoring. What’s the difference? Check out page 3: #
In some states the PDMP is “reactive” in nature, generating “solicited reports” only in response to a specific inquiry made by a prescriber, dispenser, or other party with appropriate authority. In other states the PDMP is “proactive” in nature, identifying and investigating cases, and generating “unsolicited reports” when it deems that this is warranted. #
The study does find that the proactive approach is more effective, and that a proactive monitoring program could lead to a 10 percent reduction in prescription drug abuse over a six-year period. Again, see for yourself on page 39. #
The second study cited by the article appears to be this one-page summary of findings presented at a conference of the International Society for Pharmacoeconomics and Outcomes Research. Those researchers compared prescription drug mortality rates across states, and here’s their conclusion: #
Drug-related mortality rates were lower in states with inactive programs, when compared to states with active PDMPs. This result may be representative of political pressure to enact programs in states with higher mortality rates. Although the sample size represents 20% of states, results should be viewed with caution. PDMPs are designed to decrease diversion and abuse, as well as associated morbidity and mortality; however more research is needed to determine their effectiveness and to devise ways to maximize their utility. #
So what the studies actually say is that PDMPs can be an effective tool for combating prescription drug abuse, that the states most likely to use them are the ones that need them the most (go figure), and that more research is needed. Indeed. #
