Opioid Monitoring Programs Linked to Increased Pain Reports in Older Adults, Study Finds

State policies requiring clinicians to check prescription drug monitoring databases before prescribing opioid pain relievers may be associated with increased pain among older adults in the years immediately following implementation, according to new research from Rollins School of Public Health.  

For the study, published in Medical Care Research and Review, researchers analyzed data from more than 34,000 older adults over nearly two decades to evaluate the effects of must-access prescription drug monitoring programs (PDMPs) on pain and physical impairment.

PDMPs are statewide databases that track prescriptions for controlled substances, including prescription opioids. Must-access PDMPs require prescribers to check these databases before writing opioid prescriptions. While must-access PDMPs are designed to reduce unnecessary opioid prescribing, some patients have reported experiencing more difficulty managing chronic pain after these laws were implemented.  

The study’s findings may reflect challenges patients and clinicians face when adjusting pain treatment plans during policy changes. During the study period from 2002 to 2021, 43 states plus Washington, D.C. implemented must-access requirements. 

What They Found  

• Must-access prescription drug monitoring programs were associated with an increase in the percent of older adults reporting being frequently troubled by pain in the first four to five years following program implementation.  
• The effect of must-access PDMPs on physical impairment outcomes was not significant.
• While the effects of must-access PDMPs on frequent pain waned after 5 years of implementation, these results must be interpreted cautiously, since long-term data are only available for a small number of states.

Why This Matters

"This study is one of the first to examine an unintended consequence of a policy that has been implemented by 80% of states in an attempt to combat opioid overprescribing," said Martha Wetzel, lead author and doctoral student at the Emory Rollins School of Public Health. “Pain is a costly condition that significantly affects well-being, and there may be opportunities to refine either policy or clinical practice to better address the pain management needs of older adults in the context of changing opioid policies."