OBJECTIVES:

In recent years, polysubstance-related admission to substance abuse treatment facilities is increasing. The Prescription Drug Monitoring Program (PDMP) is used to monitor the prescription of controlled substances. This study aims to investigate the effect of PDMP on the polysubstance-related admission rate.

METHODS:

We used Treatment Episode Admission Dataset from 2010 to 2019 to identify polysubstance-related admission rate among Appalachian states. In addition, University of Kentucky Center for Poverty Research’s National Welfare Data and prescription drug abuse policy system website were used to collect state-level economic and controlled substance related policy data. We used difference-in-differences (DID) model to assess the effect of PDMP on polysubstance-related admission rate among the states with mandated the PDMP vs. the states with voluntary PDMP. DID model was adjusted for state-level policy and socioeconomic factors, state, and time as fixed effects.

RESULTS:

In total, 12 Appalachian states were included, with seven mandatory PDMP and five voluntary states. More males were admitted with polysubstance use than female in both mandatory and voluntary states (Mandatory states: 67.7% male vs. 30.2% female; Voluntary states: 62.7% male vs. 37.4% female). States with mandatory PDMP showed low unemployment and poverty rate compared to states with voluntary PDMP (Mandatory states: 6.1% unemployment and 14.2% poverty rate vs. Voluntary states: 6.5% unemployment and 15.4% poverty rate). The unadjusted DID model showed no associations between PDMP and polysubstance-related admission rate (p=0.8) in both mandatory and voluntary states. Furthermore, the association between PDMP and admission rate did not change (p=0.2) after controlling for state-level policy and socioeconomic factors.

CONCLUSIONS:

This study suggested no evidence that mandatory PDMP is associated with polysubstance-related admission rate in publicly funded treatment facilities within Appalachian region.