• Yuanhong Lai Alden A a Department of Health Policy & Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA., Katherine C Smith, Jon S Vernick, Corey S Davis, Caleb Alexander G G e Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA., and Lainie Rutkow.
• a Department of Health Policy & Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , Maryland , USA.
• Subst Use Misuse. 2019 Jan 1; 54 (2): 345-349.

BackgroundOpioid-related injuries and deaths continue to present challenges for public health practitioners. Prescription Drug Monitoring Programs (PDMPs) are a prevalent policy option intended to address problematic opioid pain reliever (OPR) prescribing, but previous research has not thoroughly characterized their unintended consequences.ObjectivesTo examine state actors' perceptions of the unintended consequences of PDMPs.MethodsWe conducted 37 interviews with PDMP staff, law enforcement officials, and administrative agency employees in Florida, Kentucky, New Jersey, and Ohio from May 2015 to June 2016.ResultsWe identified six themes from the interviews. Perceived negative unintended consequences included: access barriers for those with medical needs, heroin use as OPR substitute and related deaths, and need for adequate PDMP security infrastructure and management. Perceived positive unintended consequences were: community formation and problem awareness, proactive population-level OPR monitoring, and increased knowledge about population-level drug diversion. Conclusions/Importance: State actors perceive a range of both negative and positive unintended consequences of PDMPs. Our findings suggest that there may be unintended risks of PDMPs that states should address, but also opportunities to maximize certain benefits.

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