Patients may still have opiate abuse or dependence even if they have no prescriptions recorded on a public controlled-substance database.
Why does this matter?
State run prescription drug monitoring programs (PDMP) have been helpful in curtailing prescription drug abuse. They provide valuable intelligence about what controlled substances a patient has recently had filled, assuming they are obtaining them legally. But one may have a false sense of reassurance if the PDMP shows no filled controlled substances.
"Trust no one." Corey Slovis
There was a rough correlation between number of prescriptions on a PDMP and self-reported use of an opiate 1-14 days/month or >/=15 days/month. The more prescriptions on the PDMP, the more self-reported drug use, from both prescription and non-prescription (illicit) sources. But the correlation was loose. For example, among patients with no prescriptions in the PDMP, 28% voluntarily reported using opiates >/= 15 days/month. The take home of this study was that we can't be falsely reassured by a PDMP showing no opiate prescriptions filled. Patients can have a serious opiate use disorder and not have any prescriptions on file with the state monitoring program.
Past-year Prescription Drug Monitoring Program Opioid Prescriptions and Self-reported Opioid Use in an Emergency Department Population with Opioid Use Disorder. Acad Emerg Med. 2017 Nov 22. doi: 10.1111/acem.13352. [Epub ahead of print]
Peer reviewed by Thomas Davis, MD.