Report Highlights

The Prescription Drug Monitoring Program provides an important tool to address prescription drug abuse, including opioid abuse, and help improve health outcomes. Oregon’s laws have put constraints on the program that limit its effectiveness and impact. Restrictions are placed on what data are collected, analyses that can be done with the data, and with whom information can be shared. Correcting weaknesses in Oregon’s program will maximize its potential and help address opioid and other substance abuse issues the state faces.

Background

Oregon has the highest rate in the nation of seniors hospitalized for opioid-related issues such as overdose, abuse, and dependence. The state also has the sixth highest percentage of teenage drug users. The Oregon Health Authority (OHA) manages the state’s Prescription Drug Monitoring Program (PDMP), which collects information on controlled substance prescriptions within the state. The program was designed to promote public health and safety and to help improve patient care. It was also developed to support the appropriate use of prescription drugs.

Purpose

The purpose of this audit was to determine if Oregon can better leverage its PDMP to help with the opioid epidemic.

Key Findings

  1. OHA could better use PDMP data to analyze trends in prescribed drugs, including identifying patterns of possible opioid misuse and abuse. State laws prevent OHA from sharing information with key stakeholders, such as health licensing boards and law enforcement, on questionable activity. Our analysis found people who have received opioid prescriptions from excessive numbers of prescribers, as well as instances of dangerous drug combinations and prescriptions for excessive dosages of drugs. One person who received an excessive amount of opioid prescriptions had some of those prescriptions paid for by Medicaid.
  2. Oregon is one of only nine states that does not require prescribers or pharmacies to use the PDMP database before an opioid prescription is written or dispensed. Mandating use can be effective in reducing opioid misuse and other health related outcomes.
  3. Due to statutory restrictions, Oregon’s PDMP does not collect some prescription information that could be critical in preventing prescription drug abuse. This includes prescriptions filled by pharmacies other than only retail, veterinarian prescribed prescriptions, prescriptions for Schedule V drugs and drugs known to be abused or misused such as gabapentin, and prescription details such as method of payment, lock-in status, and diagnosis information.

Recommendations

Our report includes 12 recommendations to OHA for optimizing the state’s PDMP. OHA can implement some of
these within existing statutes and rules, and for others it needs to work with the Legislature. OHA agreed with
all of the recommendations, but stated that because seven fall outside the scope of its statutory authority, its
ability to implement them is limited. The agency’s response can be found at the end of the report.

Read full report here.