Benzodiazepines

Tracking the Trail of Opioids and Benzodiazepines

The following is a summary of “Mandatory prescription drug monitoring programs and overlapping prescriptions of opioids and benzodiazepines: Evidence from Kentucky,” published in the February 2023 issue of Drug and Alcohol Dependence by Nguyen et al.

As a result of the opioid epidemic, numerous states have established mandates necessitating healthcare providers to verify prescription drug monitoring programs (PDMPs) before prescribing opioids. Our study investigates the alterations in concurrent benzodiazepine and opioid prescriptions after implementing a prescription drug monitoring program (PDMP) mandate in Kentucky in July 2012. An interrupted time series analysis was performed utilizing monthly data from Kentucky’s Prescription Drug Monitoring Program (PDMP) from 2010 to 2016. Distinct analyses were performed to evaluate overlapping prescriptions issued by a sole provider or multiple providers and stratified by gender and age cohorts. An individual-level longitudinal analysis was performed to compare alterations in utilization patterns after the mandate’s implementation with those in preceding periods when the mandate was not in effect.

The implementation of Kentucky’s prescription drug monitoring program (PDMP) resulted in an abrupt reduction of 7.5% in the frequency of concurrent prescriptions of benzodiazepines and opioids and a notable shift in the pattern from an upward trend to a downward one. Roughly 50% of the immediate impact in terms of the level was accounted for by reductions in concurrent prescriptions issued by a sole healthcare provider. Based on our longitudinal analysis, it has been observed that the mandate has resulted in a 29.3% reduction in the initiation of overlapping prescriptions and a 9.4% reduction in the continuation of overlapping prescriptions over a period of one year. The policy’s impact was most significant among individuals of both genders who were between the ages of 36 and 50. While not the primary impetus for the measure, the prescription drug monitoring program (PDMP) requirement in Kentucky effectively decreased the occurrence of concurrent prescriptions for benzodiazepines and opioids. Additional measures aimed at minimizing the occurrence of overlapping prescriptions ought to consider the impact on specific demographic groups, such as females aged 50 and above, who exhibit an elevated prevalence of overlapping prescriptions.

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