When Are Prescribers Required to Use Prescription Drug Monitoring Programs?

Data show mandates vary across states

A data visualization from   A data visualization from The Pew Charitable Trusts

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
{{ currentSystemText }}: {{ currentMeasureText }}

Comparative chart of systems

State selection 1
State 1
{{ state1.state === 'Select a state' ? 'Select' : state1.stateAbbrev }}{{ state1.universalPDMPUse ? '*' : '' }} {{ state1.state }}{{ state1.universalPDMPUse ? '*' : '' }}
  • {{ state.state === 'Select a state' ? 'Clear' : state.stateAbbrev }}{{ state.universalPDMPUse ? '*' : '' }} {{ state.state === 'Select a state' ? 'Clear selection' : state.state }}{{ state.universalPDMPUse ? '*' : '' }}
State selection 2
State 2
{{ state2.state === 'Select a state' ? 'Select' : state2.stateAbbrev }}{{ state2.universalPDMPUse ? '*' : '' }} {{ state2.state }}{{ state2.universalPDMPUse ? '*' : '' }}
  • {{ 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
{{ state3.state === 'Select a state' ? 'Select' : state3.stateAbbrev }}{{ state3.universalPDMPUse ? '*' : '' }} {{ state3.state }}{{ state3.universalPDMPUse ? '*' : '' }}
  • {{ 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?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.typeOfMandate1 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.typeOfMandate1 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.typeOfMandate1 }}
  1. {{ state1.typeOfMandate1Fn }}
  2. {{ state2.typeOfMandate1Fn }}
  3. {{ state3.typeOfMandate1Fn }}

Drugs included

What drugs are included in the mandate?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.drugsIncluded1 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.drugsIncluded1 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.drugsIncluded1 }}
  • 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.
  1. {{ state1.drugsIncluded1Fn }}
  2. {{ state2.drugsIncluded1Fn }}
  3. {{ state3.drugsIncluded1Fn }}

Timing triggers

Is the prescriber required to review the PDMP for the initial prescription for drugs that are subject to the mandate?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.timingTriggers1 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.timingTriggers1 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.timingTriggers1 }}
Is the prescriber required to review the PDMP at regular intervals after the initial prescription?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.timingTriggers2 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.timingTriggers2 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.timingTriggers2 }}
Are there other timing triggers?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.timingTriggers3 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.timingTriggers3 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.timingTriggers3 }}
  1. {{ state1.timingTriggers1Fn }}
  2. {{ state2.timingTriggers1Fn }}
  3. {{ state3.timingTriggers1Fn }}
  4. {{ state1.timingTriggers2Fn }}
  5. {{ state2.timingTriggers2Fn }}
  6. {{ state3.timingTriggers2Fn }}
  7. {{ state1.timingTriggers3Fn }}
  8. {{ state2.timingTriggers3Fn }}
  9. {{ state3.timingTriggers3Fn }}

Exceptions to PDMP review

Are short duration prescriptions exempt from the mandate?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.exceptions1 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.exceptions1 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.exceptions1 }}
Are prescriptions for terminally ill patients exempt from PDMP review?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.exceptions2 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.exceptions2 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.exceptions2 }}
Are prescriptions issued or administered at hospitals and long-term care facilities exempt from the mandate?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.exceptions3 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.exceptions3 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.exceptions3 }}
Is there an exception to the mandate if the PDMP is inaccessible?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.exceptions4 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.exceptions4 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.exceptions4 }}
Are there other exceptions?
{{ state1.state === 'Select a state' ? '--' : state1.state }}
{{ state1.state === 'Select a state' ? '--' : state1.exceptions5 }}
{{ state2.state === 'Select a state' ? '--' : state2.state }}
{{ state2.state === 'Select a state' ? '--' : state2.exceptions5 }}
{{ state3.state === 'Select a state' ? '--' : state3.state }}
{{ state3.state === 'Select a state' ? '--' : state3.exceptions5 }}
  1. {{ state1.exceptions1Fn }}
  2. {{ state2.exceptions1Fn }}
  3. {{ state3.exceptions1Fn }}
  4. {{ state1.exceptions2Fn }}
  5. {{ state2.exceptions2Fn }}
  6. {{ state3.exceptions2Fn }}
  7. {{ state1.exceptions3Fn }}
  8. {{ state2.exceptions3Fn }}
  9. {{ state3.exceptions3Fn }}
  10. {{ state1.exceptions4Fn }}
  11. {{ state2.exceptions4Fn }}
  12. {{ state3.exceptions4Fn }}
  13. {{ state1.exceptions5Fn }}
  14. {{ state2.exceptions5Fn }}
  15. {{ state3.exceptions5Fn }}
Report

Prescription Drug Monitoring Programs

Learn More
Quick View
Report

Prescription Drug Monitoring Programs

The prescription opioid epidemic poses major threats to the nation’s health. According to the Centers for Disease Control and Prevention, approximately 19,000 people in the United States died from overdoses involving prescription opioids in 2014—a 16 percent increase from the previous year, and the highest number ever recorded.

Learn More
1x1placeholder
Data Visualization

Strategies to Optimize Prescriber Use of Prescription Drug Monitoring Programs

Learn More
Quick View
Data Visualization

Strategies to Optimize Prescriber Use of Prescription Drug Monitoring Programs

Nearly 19,000 people in the United States died from overdoses that involved prescription pain relievers, also known as opioids, in 2014. This represents a 16 percent increase from the previous year and is the highest number recorded—equivalent to 52 deaths each day.

Learn More
Composite image of modern city network communication concept

Learn the Basics of Broadband from Our Limited Series

Sign up for our four-week email course on Broadband Basics

Quick View

How does broadband internet reach our homes, phones, and tablets? What kind of infrastructure connects us all together? What are the major barriers to broadband access for American communities?

What Is Antibiotic Resistance—and How Can We Fight It?

Sign up for our four-week email series The Race Against Resistance.

Quick View

Antibiotic-resistant bacteria, also known as “superbugs,” are a major threat to modern medicine. But how does resistance work, and what can we do to slow the spread? Read personal stories, expert accounts, and more for the answers to those questions in our four-week email series: Slowing Superbugs.