Prescription Drug Monitoring Programs and Their Impact on IPV

The Role of Prescription Drug Monitoring Programs in Healthcare

Prescription Drug Monitoring Programs (PDMPs) have emerged as critical tools in the healthcare arena for combating the opioid crisis. These state-run electronic databases track the prescribing and dispensing of controlled substances. PDMPs serve to inform healthcare providers about a patient’s prescription history, aiming to mitigate the risks associated with opioid misuse. By mandating healthcare providers to consult PDMPs before prescribing opioids, these programs target the problematic practice of “doctor shopping,” where patients obtain prescriptions from multiple providers (Buchmueller & Carey, 2018).

In the context of healthcare, PDMPs address the dual objective of ensuring patients have access to necessary medications while simultaneously curbing the potential for substance misuse. The implementation of these programs has shown promising results, particularly in states that have adopted mandatory-access PDMPs, significantly reducing opioid prescriptions and misuse (Grecu et al., 2019). The overarching goal is to balance appropriate pain management with public safety, marking a paradigm shift in how healthcare systems manage prescribing practices.

Effects of Mandatory Access PDMPs on Opioid Misuse

The adoption of mandatory-access PDMPs has led to a notable decrease in opioid prescriptions across various states. Studies have demonstrated that these programs effectively reduce prescription opioid misuse and associated overdose fatalities, which reached alarming levels in the U.S. over the past two decades (Dave et al., 2021). The findings suggest that states with stringent PDMP regulations have seen a marked decline in opioid prescriptions, particularly among high-risk populations (Kim, 2021).

One of the key findings from the literature is the significant lag effect associated with these policies. For example, it can take several years for the full impact of mandatory-access PDMPs to manifest in reduced opioid misuse rates. This delay may be attributed to several factors, including the time required for healthcare providers to adapt to new regulations and for patients to adjust to restricted access to prescription opioids (Grecu et al., 2019).

Table 1: Trends in Opioid Prescription Rates and Mandatory PDMP Adoption

Impacts of PDMPs on Women’s Well-Being and IPV Rates

Emerging research highlights the connection between PDMPs and intimate partner violence (IPV). The opioid crisis has deep societal repercussions, particularly affecting women who are victims of IPV. A study by Dave et al. (2023) found that the implementation of mandatory-access PDMPs resulted in a reduction of IPV incidents reported by women, with estimates suggesting a decrease of approximately 9% over a six-year period post-implementation.

The mechanisms behind this relationship are multi-faceted. Reductions in prescribed opioids can lessen the potential for substance abuse among partners, which is a known risk factor for IPV perpetration. Moreover, as opioid misuse declines, the associated negative behaviors and economic stressors that often exacerbate IPV situations may also diminish, thereby fostering a safer environment for women (Dave et al., 2023). However, it is essential to note that while PDMPs have beneficial effects, they have also been linked to increases in heroin-related IPV incidents, suggesting a potential substitution effect where individuals move from prescription opioids to illicit substances (Kim, 2021).

Substitution Effects: From Prescription Opioids to Heroin

As PDMPs restrict access to prescription opioids, there is a documented trend of individuals substituting these substances with heroin. This substitution is concerning, as heroin use is often associated with more severe behavioral consequences, including increased rates of IPV. In fact, studies have indicated a significant rise in heroin-involved IPV incidents following the implementation of mandatory-access PDMPs, although these incidents account for a small proportion of total IPV cases (Dave et al., 2023).

This dynamic underscores the complexity of addressing substance misuse through regulatory measures. While PDMPs aim to limit opioid prescriptions and reduce associated harms, they inadvertently create a pathway to more dangerous illicit substances. Therefore, addressing the opioid crisis requires a comprehensive approach that includes monitoring not only prescription practices but also the potential for illicit drug use.

Addressing the Stigma Surrounding Substance Use and IPV

Stigma surrounding substance use and mental health remains a significant barrier to effective intervention and support for victims of IPV. Individuals suffering from substance use disorders often face discrimination that discourages them from seeking help. This stigma can exacerbate feelings of isolation and hopelessness, further entrenching their circumstances (Rikard et al., 2025). To combat these issues, public health initiatives must prioritize destigmatization efforts alongside policy measures like PDMPs.

Education and awareness campaigns are essential for reducing stigma and fostering empathy towards individuals struggling with substance use and those affected by IPV. By promoting understanding and support, these initiatives can empower victims to seek assistance and navigate their situations more effectively. Additionally, healthcare providers must receive training on the implications of stigma and the importance of compassionate care when addressing issues related to substance use and IPV.

Frequently Asked Questions (FAQ)

What are Prescription Drug Monitoring Programs (PDMPs)?

PDMPs are state-run electronic databases that track the prescribing and dispensing of controlled substances. Their primary purpose is to inform healthcare providers about a patient’s prescription history to prevent misuse.

How do PDMPs affect opioid misuse?

Mandatory-access PDMPs have been shown to significantly reduce opioid prescriptions and misuse. They help to prevent “doctor shopping” and ensure that patients only receive necessary medications.

Can PDMPs help reduce intimate partner violence (IPV)?

Yes, studies suggest that the implementation of mandatory-access PDMPs is associated with a reduction in reported IPV incidents among women. This effect is likely due to decreased substance abuse among partners.

What are the unintended consequences of PDMPs?

While PDMPs have beneficial effects on reducing prescription opioid misuse, they have also been linked to an increase in heroin use, which can lead to more severe forms of IPV.

How can stigma surrounding substance use and IPV be addressed?

Public health initiatives must focus on education and awareness campaigns to reduce stigmTraining for healthcare providers on empathetic communication is also crucial for supporting individuals affected by substance use and IPV.

References

1. Buchmueller, T. C., & Carey, C. (2018). The effect of prescription drug monitoring programs on opioid utilization in Medicare. American Economic Journal: Economic Policy, 10(1), 77–112. doi:10.1257/pol.20160094

2. Dave, D. M., Erten, B., Keskin, P., & Zhang, S. (2023). From addiction to aggression: the spillover effects of opioid policies on intimate partner violence. Working Paper 31609, National Bureau of Economic Research.

3. Dave, D., Deza, M., & Horn, B. (2021). Prescription drug monitoring programs, opioid abuse, and crime. Southern Economic Journal, 87(3), 808–848. doi:10.1002/soej.12481

4. Grecu, A., Kuo, C., & Haffajee, R. L. (2019). The impact of prescription drug monitoring programs on opioid prescribing and overdose mortality: a systematic review. Journal of Pain Research, 12, 2995–3008. doi:10.2147/JPR.S197181

5. Kim, D. (2021). An examination of the impact of prescription drug monitoring programs on opioid overdoses and heroin use. Journal of Drug Issues, 51(2), 175–195. doi:10.1177/0022042620961849

6. Rikard, S. M., Doshi, K., Guy, G. P. Jr, & Schmit, K. M. (2025). Awareness of and beliefs about naloxone among adults. JAMA Health Forum. doi:10.1001/jamahealthforum.2025.1867

7. Smith, S. G., Zhang, X., Basile, K. C., Merrick, M. T., Wang, J., Kresnow, M., & Chen, J. (2022). The National Intimate Partner and Sexual Violence Survey (NISVS): 2015 Data Brief – Updated Release. Centers for Disease Control and Prevention.

8. Volkow, N. D. (2014). Prescription opioid and heroin abuse. The New England Journal of Medicine, 370(3), 221–223. doi:10.1056/NEJMp1310694