Prescription Drug Overdose Prevention for States (PfS) Program

Comparing the effects of strategies for reducing opioid misuse and overdose

Client
Centers for Disease Control and Prevention

Two-thirds of drug overdoses in the United States involve opioids, and 91 Americans die each day from opioid overdose. Every day, more than 1,000 people are treated in emergency departments across the nation for misusing prescription opioids.

Escalating rates of opioid misuse have been linked to increases in accidental overdose deaths and outbreaks of HIV and hepatitis C infection.

To address these problems, in 2015 the Centers for Disease Control and Prevention (CDC) launched a program to support efforts to reduce opioid misuse and accidental overdose deaths in 16 states.  In 2016, CDC expanded the program to include an additional 13 states.  

Monitoring Opioid Prescriptions to Reduce Misuse and Accidental Deaths

Under the Prescription Drug Overdose Prevention for States (PfS) Program, CDC provides funding for 29 participating states to enhance prescription drug monitoring programs (PDMPs). PDMPs are databases used to track the prescribing and dispensing of prescription drugs that are also controlled substances, with the goal of reducing inappropriate prescribing and opioid misuse. The PfS program also provides funding for states to implement other evidence-based strategies for reducing accidental deaths from opioid overdose.

As part of its analysis of the program, CDC engaged our experts to evaluate the impact of each state’s prevention activities on short-, intermediate-, and long-term outcomes. The goals of these efforts are to prevent misuse of opioids and to reduce the number of accidental opioid overdose deaths and related emergency room visits.   

Merging Data Sources about State-Run Programs to Combat Opioid Abuse

Drawing on extensive experience in program evaluation and data science, our experts are collaborating with CDC program officials to combine data from the participating 29 states with data from the National Survey on Drug Use and Health, Treatment Episode Dataset, and the National Prescription Audit, as well as other sources.

The analyses and interpretation of our experts in behavioral health, drug addiction, and drug abuse prevention benefits this data-centric approach.

As states submit annual progress reports to CDC, our team prepares the data for analysis. Initial analyses focus on identifying strategies being implemented, assessing how states are operationalizing those strategies, and capturing implementation dates to support future comparison. 

Subsequent analyses will examine short- and intermediate-term outcomes of combined strategies implemented in individual states and clusters of states. For example, some states are considering new laws to mandate registration and use of PDMPs, or to allow physicians and pharmacists to delegate data entry in PDMPs to nurses or technicians. Our team will evaluate short-term outcomes such as reduced barriers to PDMP registration, and implementation of interventions targeting physicians and pharmacists to reduce the number of opioid prescriptions.  Examples of intermediate-term outcomes we will evaluate include decreased rates of high-dose opioid prescriptions and decreased co-prescribing of benzodiazepines.  These analyses will adjust for socio-demographic characteristics and the magnitude of the opioid problem in each state. 

Because long-term outcomes—such as reduction in deaths from opioid overdose—may not be evident until after the five-year PfS funding expires, our experts will use predictive simulation models to project the impact of the PfS program at 10, 15, and 20 years beyond the life of the program.

As the PfS program expands, our evaluation of outcomes in the initial cohort of states will support the need to identify effective state-run approaches for curbing opioid abuse and addiction. With evidence-based information, CDC and individual states can allocate resources toward interventions with the greatest promise and make strides toward ending the opioid crisis in the United States.