Usefulness of prescription monitoring programs for surveillance-analysis of Schedule II opioid prescription data in Massachusetts, 1996-2006

Purpose Electronic prescription monitoring programs (PMPs) have been developed in many states as a public health surveillance tool. We analyze herein 11 years of Massachusetts PMP data to evaluate trends in opioid prescribing, dispensing, and usage. Methods Prescription records from the Massachusetts PMP for Schedule 11 opioids from fiscal year 1996 to 2006 were analyzed. 'Questionable activity' (potential 'doctor shopping') estimates were based on individual use of multiple prescribers and pharmacies, and early refills. Results The number of prescriptions, doses prescribed, and individuals receiving Schedule 11 prescription opioids steadily increased from 1996 to 2006. Most individuals (87.5%) used 1-2 prescribers, 1-2 pharmacies, and had no early refills (2006). The greater the number of prescribers used, the greater the number of pharmacies used. When defined as the use of >= 4 prescribers and >= 4 pharmacies, questionable activity accounted for 2748 individuals, 47 953 prescriptions, and 2 966 056 doses (2006). The Schedule 11 opioid most highly associated with questionable activity was short-acting oxycodone. Conclusions PMPs can become a useful public health surveillance tool to monitor the medical and non-medical use of prescription opioids and to inform public health and safety policy. Copyright (C) 2009 John Wiley & Sons, Ltd.